Graversen Ida-Marie Dons, Pedersen Steen Bønløkke, Møller Trine Boje, Aagaard Mikkel, Pedersen Charlotte Gjørup
Department of Public Health, Aarhus University, Aarhus, Denmark.
Steno Diabetes Center Aarhus, Aarhus, Denmark.
J Multimorb Comorb. 2025 Apr 30;15:26335565251333877. doi: 10.1177/26335565251333877. eCollection 2025 Jan-Dec.
Patients with multiple chronic conditions often face fragmented care and inconsistent information, increasing their risk of serious health issues. Their perceived collaboration across clinics may be shaped by difficulties in accessing and using information for informed decision-making. This study explored the association between patient-perceived collaboration across clinics and health literacy among outpatients with diabetes and at least one comorbidity at the hospital level. This cross-sectional study at the outpatient clinic at Steno Diabetes Center Aarhus included all patients with diabetes and at least one comorbidity who were simultaneously receiving treatment at another outpatient clinic within the hospital. The association between patient-perceived extensive collaboration across clinics (exposure) and patient health literacy (outcome) was assessed using four selected scales and regression models. Results were presented as both unadjusted and adjusted, accounting for potential confounders. A total of 3,435 outpatients received a survey, with 1,655 responses. Of these, 686 reported receiving cross-clinic treatment. Among the 552 respondents who answered the exposure-related question, 44.7% perceived extensive collaboration across clinics, while 55.3% perceived limited collaboration. Statistically significant differences were found in three out of four health literacy scales, with those who perceived limited collaboration scoring lower in areas related to managing their health and engaging with healthcare providers. The findings suggest that outpatients with comorbidities and perceived poor clinic collaboration may have low health literacy, highlighting the need to address this in their treatment and communication with healthcare providers. Future research is needed to determine whether limited perception arises from personal challenges, elements of the treatment process, or relational and organizational issues across clinics, in order to improve the perception of collaboration and clinical outcomes.
患有多种慢性病的患者常常面临医疗服务碎片化和信息不一致的问题，这增加了他们出现严重健康问题的风险。他们对各诊所之间协作的认知可能受到获取和使用信息以做出明智决策的困难的影响。本研究探讨了在医院层面，糖尿病门诊患者以及至少患有一种合并症的患者对各诊所间协作的认知与健康素养之间的关联。这项在奥胡斯斯滕诺糖尿病中心门诊进行的横断面研究纳入了所有患有糖尿病且至少有一种合并症、同时在医院内另一门诊接受治疗的患者。使用四个选定的量表和回归模型评估了患者对各诊所间广泛协作的认知（暴露因素）与患者健康素养（结果）之间的关联。结果以未调整和调整后的形式呈现，同时考虑了潜在的混杂因素。共有3435名门诊患者接受了调查，收到1655份回复。其中，686人报告接受了跨诊所治疗。在回答了与暴露因素相关问题的552名受访者中，44.7%的人认为各诊所间有广泛协作，而55.3%的人认为协作有限。在四个健康素养量表中的三个量表上发现了统计学上的显著差异，认为协作有限的人在与管理自身健康以及与医疗服务提供者互动相关的领域得分较低。研究结果表明，患有合并症且认为诊所间协作不佳的门诊患者可能健康素养较低，这凸显了在他们的治疗以及与医疗服务提供者沟通中解决这一问题的必要性。未来需要开展研究，以确定协作认知有限是源于个人挑战、治疗过程中的因素，还是诊所间的关系和组织问题，从而改善协作认知和临床结果。
