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与常规就医来源相关的初级卫生保健患者感知服务质量概况:一项潜在概况分析。

Patient perceived service quality profiles of primary health care associated with usual source of care: a latent profile analysis.

作者信息

Zhang Li, Wang Baokai, Xu Qi

机构信息

School of Health Management, Binzhou Medical University, Yantai, Shandong, China.

Yantai Yuhuangding Hospital, Yantai, Shandong, China.

出版信息

Front Med (Lausanne). 2025 Jun 26;12:1592803. doi: 10.3389/fmed.2025.1592803. eCollection 2025.

Abstract

BACKGROUND

Under the context that the Chinese government has taken many incentives to promote the development of primary health care (PHC), the extent to which patients choose PHC as their usual source of care (USC) and how patient perceived service quality affects this choice remains unclear. This study aimed to explore potential profiles of patient perceived service quality of PHC, analyse sociodemographic and health-related characteristics among perceived service quality subgroups, and investigate the association between patient perceived service quality and usual source of PHC.

METHODS

A cross-sectional survey was conducted in Shandong Province, China, from July 2023 to August 2023. 3025 patients were selected using a multistage stratified sampling method. Latent profile analysis was used to explore the profiles of patient perceived service quality of PHC. Multiple logistic regression analysis was adopted to identify the predictors of different profiles, and the binary logistic regression was used to examine the association between perceived service quality profiles and usual source of PHC.

RESULTS

The model fitting indices of patient perceived service quality supported three profiles which were as follows: low perceived service quality group at 20.23%, moderate perceived service quality group at 56.50%, and high perceived service quality group at 23.27%. Age, educational level, personal monthly income, and self-rated health were predictors of different profiles. Furthermore, patients reporting high perceived service quality of PHC were more likely to regard PHC as the USC compared with those with low perceived service quality (OR = 2.748, 95% confidence interval = 2.112-3.575).

CONCLUSION

Strengthening patient perceived service quality can encourage them to regard PHC facilities as the USC. PHC facilities should provide customized and tailored health services that focus on individuals' specific needs and preferences to improve patient perceived service quality.

摘要

背景

在中国政府采取诸多激励措施促进基层医疗卫生服务(PHC)发展的背景下,患者选择基层医疗卫生服务作为其常规就医渠道(USC)的程度以及患者感知的服务质量如何影响这一选择仍不明确。本研究旨在探索基层医疗卫生服务患者感知服务质量的潜在类型,分析感知服务质量亚组间的社会人口学和健康相关特征,并调查患者感知服务质量与基层医疗卫生服务常规就医渠道之间的关联。

方法

于2023年7月至2023年8月在中国山东省进行了一项横断面调查。采用多阶段分层抽样方法选取了3025名患者。运用潜在类别分析来探索基层医疗卫生服务患者感知服务质量的类型。采用多因素logistic回归分析确定不同类型的预测因素,并使用二元logistic回归检验感知服务质量类型与基层医疗卫生服务常规就医渠道之间的关联。

结果

患者感知服务质量的模型拟合指数支持三种类型,分别为:低感知服务质量组占20.23%,中等感知服务质量组占56.50%,高感知服务质量组占23.27%。年龄、教育水平、个人月收入和自评健康状况是不同类型的预测因素。此外,与低感知服务质量的患者相比,报告基层医疗卫生服务感知服务质量高的患者更有可能将基层医疗卫生服务视为常规就医渠道(OR = 2.748,95%置信区间 = 2.112 - 3.575)。

结论

加强患者感知服务质量可促使他们将基层医疗卫生机构视为常规就医渠道。基层医疗卫生机构应提供针对个人特定需求和偏好的定制化健康服务,以提高患者感知服务质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/952f/12241076/be04e0a9715a/fmed-12-1592803-g001.jpg

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