Aljohani Motab, Donnelly Michael, O'Neill Ciaran
Public Health Department, College of Health Science, Saudi Electronic University, Riyadh, Saudi Arabia.
Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland.
PLoS One. 2025 Jan 7;20(1):e0313168. doi: 10.1371/journal.pone.0313168. eCollection 2025.
Given the importance of GP care to the public's health, it is important that we understand how patterns of service use change as levels of investment change. This study investigated GP use in Britain in conjunction with use of outpatient services during a period of investment and during a period of austerity.
The study used data from the British Household Panel Survey (BHPS) that included service use, morbidity (as an indicator of need) and socio-demographic characteristics (e.g., employment, age, education, and sex). Data for 2000, 2004, and 2008, were specifically chosen for comparison with data from 2015, 2016 and 2017. Service use and respondent characteristics were described using measures of central tendency and dispersion. Multivariable analyses were undertaken using recursive bivariate probit (RBVP) and probit analyses separately for each study year. All analyses were adjusted for cross-sectional weighting.
BHPS respondents who used outpatient services or GP services had higher morbidity compared to survey participants who did not. Older people, people with lower educational attainment and employed people had higher mean morbidity indices in each study year as did females. Morbidity among service users tended to decline slightly over time. RBVP analyses revealed a significant positive correlation in residuals between outpatient and GP functions in 2000 and 2004 but not 2008. GP consultations and outpatient use remained largely unrelated to socio-economic factors in each year. Survey participants who reported hearing or vision impairment conditions were consistently less likely to use GP or outpatient services in 2000 and 2004, in 2008.
The results are broadly indicative of stable relationships in service use during a period of healthcare investment but change during austerity. Those who reported, vision, hearing, and skin conditions were consistently less likely to report use of GP or outpatient services, controlling for other aspects of health.
鉴于全科医生护理对公众健康的重要性，了解服务使用模式如何随投资水平的变化而改变非常重要。本研究调查了英国在投资期和紧缩期内全科医生服务的使用情况以及门诊服务的使用情况。
该研究使用了英国家庭调查小组（BHPS）的数据，其中包括服务使用情况、发病率（作为需求指标）和社会人口特征（如就业、年龄、教育程度和性别）。特别选取了2000年、2004年和2008年的数据与2015年、2016年和2017年的数据进行比较。使用集中趋势和离散度指标描述服务使用情况和受访者特征。分别对每个研究年份使用递归双变量概率单位（RBVP）和概率单位分析进行多变量分析。所有分析均针对横截面权重进行了调整。
与未使用门诊服务或全科医生服务的调查参与者相比，使用这些服务的BHPS受访者发病率更高。在每个研究年份，老年人、教育程度较低的人、就业人员以及女性的平均发病率指数都较高。随着时间的推移，服务使用者的发病率往往略有下降。RBVP分析显示，2000年和2004年门诊和全科医生服务功能的残差之间存在显著正相关，但2008年不存在。每年，全科医生诊疗和门诊使用情况在很大程度上仍与社会经济因素无关。在2000年、2004年和2008年，报告有听力或视力障碍的调查参与者使用全科医生或门诊服务的可能性始终较低。
结果大致表明，在医疗保健投资期间服务使用关系稳定，但在紧缩期间会发生变化。在控制了健康的其他方面后，报告有视力、听力和皮肤疾病的人使用全科医生或门诊服务的可能性始终较低。
