Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study

Teng, Li; Liu, Yueping

doi:10.1136/bmjopen-2021-054783

Cited by 7 publications

(6 citation statements)

References 30 publications

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“…This study revealed that older patients and those with a lower income are more likely to take community-based primary care facilities as a first choice for medical attention. These results are consistent with the findings of previous studies [ 30 – 32 ]. Obviously, financial concern has continued to play an important role in the patient choice of care providers despite near universal coverage of social health insurance programs in China [ 33 ].…”

Section: Discussionsupporting

confidence: 94%

Patient experience in community health services and first choice for medical attention: A cross-sectional study in Wuhan, China

Tang¹,

Fang²,

Bai³

et al. 2023

PLoS ONE

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Objectives In China, it is up to the patients to choose between hospitals and primary care facilities to initiate their medical care. This study aimed to determine the association between patient experience with community health centres (CHCs, a predominant provider of community-based primary care) and patient preference of taking community-based primary care facilities as a first choice for medical attention. Methods A questionnaire survey was conducted on 1919 patients who sought medical care in 55 CHCs in Wuhan, China. Respondents were asked to identify their preferred first choice for medical attention and rate their satisfaction with eight aspects of CHCs (basic facility, medical equipment, medical services, nursing services, treatment process, courtesy and responsiveness, time spent with medical doctor, pharmacy services). Multivariate logistic regression models were established to determine the association between the CHC experience and the first choice of providers after adjustment for variations in sociodemographic characteristics. Results Over 90% of respondents were satisfied or very satisfied with the eight aspects of CHCs; but only 75% preferred to take community-based primary care facilities as their first choice for medical attention. Those who were older and had a lower income were more likely to choose community-based primary care facilities. Geographic proximity and higher levels of satisfaction with the basic facility, courtesy and responsiveness, and pharmacy services in the CHCs were associated with a higher likelihood of taking community-based primary care facilities as a first choice for medical attention. Conclusion The consumers of CHCs are generally satisfied with the services they received. However, one quarter of the CHC patients are yet to be convinced to accept community-based primary care facilities as a preferred first provider for medical care. Geographic proximity and patient experience with CHCs are associated with the patient choice.

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Section: Discussionsupporting

confidence: 94%

Patient experience in community health services and first choice for medical attention: A cross-sectional study in Wuhan, China

Tang¹,

Fang²,

Bai³

et al. 2023

PLoS ONE

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“…As a result, the convenience and accessibility advantages offered by primary health care institutions will no longer be evident. There is an urgent need to improve their ability to attract patients 12 . Nonetheless, this also contradicts some of the studies.…”

Section: Discussionmentioning

confidence: 99%

Does a Higher Sense of Gain to Primary Health Care Institutions Lead to a Greater Frequency of First Contact?

Lin,

Lv,

et al. 2023

Preprint

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Background China hopes to reach the policy goal of patients' first contact with primary health care (PHC) institutions through several health care reform policies. Sense of gain is an essential yardstick for measuring reform proposed in China in recent years. However, how high are patients' "sense of gain" (SG) and frequency of first contact with PHC institutions in China, and what is the relationship between the two? These questions still need findings from relevant empirical studies. Methods An empirical study was conducted using descriptive statistics, correlation analysis, and robust ordered logistic regression methods based on objective statistics from 50 randomly sampled cities in mainland China in 2018 and subjective survey data on access to PHC institutions in 2020. Results In this study, we found that patients' sense of gain to PHC institutions in China in 2020 was medium, and the frequency of patients' first contact with PHC institutions "frequently" and above was low. Different aspects of patients' sense of gain to PHC institutions had a differential impact on the frequency of first contact to PHC institutions. There is a significant positive effect on patients' sense of quantity, quality, equity, and improvement of PHC, but no significant effect on accessibility. Patients' sense of gain to PHC institutions has a differential effect on the frequency of first contact with PHC institutions in different ranks of cities. Sense of quantity has a significant effect only in higher-rank cities. In contrast, the sense of quality and improvement has a significant effect only in lower-rank cities. Conclusion It is necessary for the government to scientifically consider the development status of cities of different ranks and pay attention to the actual demand and expectation of patients for PHC. Then effectively improve patients' sense of gain to achieve the policy goal of patients' first contact with PHC institutions.

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“…This study employed the Anderson behavioural model as a theoretical framework to assess the desire and determinants influencing the selection of hospice facilities among the elderly population in China, with the aim of providing recommendations for further enhancing the growth of hospice care institutions. Andersen’s behavioural model of health service utilisation was initially developed in the late 1960s and serves as a theoretical framework for analysing the factors that influence medical service utilisation 16. As many countries are yet to establish a robust hospice care system, our study can offer valuable insights into how such systems can be developed and tailored according to each country’s unique cultural context and healthcare infrastructure.…”

Section: Introductionmentioning

confidence: 99%

“…Andersen’s behavioural model of health service utilisation was initially developed in the late 1960s and serves as a theoretical framework for analysing the factors that influence medical service utilisation. 16 As many countries are yet to establish a robust hospice care system, our study can offer valuable insights into how such systems can be developed and tailored according to each country’s unique cultural context and healthcare infrastructure. By delving deeper into these factors, we aim not only to provide recommendations for further enhancing the growth of hospice care institutions in China but also contribute towards fostering a more compassionate and supportive environment globally for individuals approaching the end of life.…”

Section: Introductionmentioning

confidence: 99%

Analysis on the willingness and influencing factors of choosing hospice care service institutions among among older people in Wuhu, China: a cross-sectional study

Yang,

Zhou,

Hong

et al. 2024

BMJ Open

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ObjectiveThe purpose of this study was to evaluate the inclination and determinants influencing the selection of hospice care service institutions among elderly individuals in China.DesignThe study conducted has a cross-sectional design.SettingThe study was conducted at four urban community centres in Wuhu, Anhui Province, China.ParticipantsThe sample consisted of 642 older adults, with ages ranging from 60 to over (mean age=71.03 years, SD=7.18).MethodThis study, based on the Anderson model, developed a questionnaire after conducting a preliminary survey and engaging in several group discussions. The final questionnaire encompassed the basic information, health status, attitude towards hospice care, choice of hospice care institutions and reasons of the older people. A regional population study was conducted using the Logistic regression model to estimate the ORs (OR) of influencing factors selected by hospice services.Results38.5% of respondents expressed their willingness to receive hospice care, while 22.3% were unwilling and 39.3% felt ambivalent towards it. The acceptance rate of older people in hospice care increases with higher levels of education and monthly income. 47.0% of older people opted for hospice care in a general hospital ward, indicating that demand for hospice services among older people in Wuhu City is primarily focused on such wards. The univariate analysis revealed significant differences in the willingness of older individuals to accept hospice care services based on gender, age, educational attainment and income levels. Regardless of the location of hospice care, older men had a lower likelihood of being willing to use hospice services compared with older women. The proportion of older women choosing a hospice ward or general hospital was 53.8%, which was higher than that of older men at 42.0%. The proportion of older men choosing a community health service institution was 31.6%, higher than 23.3% of women. The educational level differences significantly influence the older people’s inclination towards receiving hospice care.ConclusionWith the ageing population of Wuhu City on the rise, there is an increasing demand for hospice services. In their final journey, older individuals require multilevel hospice care services, which necessitates equipping general hospitals with hospice wards and using community health service centres to meet their specific needs.

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Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study

Cited by 7 publications

References 30 publications

Patient experience in community health services and first choice for medical attention: A cross-sectional study in Wuhan, China

Patient experience in community health services and first choice for medical attention: A cross-sectional study in Wuhan, China

Does a Higher Sense of Gain to Primary Health Care Institutions Lead to a Greater Frequency of First Contact?

Analysis on the willingness and influencing factors of choosing hospice care service institutions among among older people in Wuhu, China: a cross-sectional study

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