Association of the Length of Doctor-Patient Relationship with Primary Care Quality in Seven Family Practices in Korea

Abstract

Countries with historically unlimited patient choice of medical provider, such as Korea, have been promoting rational health care pathways. Factors related to the length of doctor-patient relationship (DPR) for enhancing primary care in those countries should be studied. Participants were patients who had visited their family practices on six or more occasions over a period of more than 6 months. Five domains (21 items) of the Korean Primary Care Assessment Tool (first contact, coordination function, comprehensiveness, family/community orientation, and personalized care) and general questions were administered in the waiting rooms. From seven practices, the response rate was 83.7% (495/591). The older the age, the lower the income, the shorter the duration of education, the more the number of diseases the patients had, and in provincial cities rather than in Seoul, the longer length of DPR ( ≥ 4 yr) was shown. The long-term DPR was associated with total primary care quality score (upper [ ≥ 71.4] vs lower [ < 71.4], OR, 1.74; 95% CI, 1.10-2.76), especially with coordination function (OR, 1.01; 95% CI, 1.00-1.02), being adjusted for confounding variables. Strengthening the coordination function may have to be the first consideration in primary care policy in countries like Korea.

Comparison of patient perceptions of primary care quality across healthcare facilities in Korea: A cross-sectional study

“…[18] The strength of the Korean primary care system was reported as the weakest among the Organisation for Economic Cooperation and Development (OECD) countries. [19] Many unique features of the Korean context have hindered the establishment of a primary care system, including the nominal patient referral system without a gatekeeping function, [17,[20][21][22][23] fee-for-service schedule, [18] overproduction of specialists and sub-specialties, [20,24] and private sector dominance. [22] Hospitals in Korea operate large-scale outpatient units, providing primary care as well as secondary/tertiary care services.…”

“…[19] Many unique features of the Korean context have hindered the establishment of a primary care system, including the nominal patient referral system without a gatekeeping function, [17,[20][21][22][23] fee-for-service schedule, [18] overproduction of specialists and sub-specialties, [20,24] and private sector dominance. [22] Hospitals in Korea operate large-scale outpatient units, providing primary care as well as secondary/tertiary care services. [21] Due to the absence of functional gatekeeping (virtually equivalent to direct access to hospitals), [23,24] hospital ambulatory care has been over-utilized, and many hospitals in turn have expanded their outpatient units.…”

Evaluating the Primary Care Quality of a Public Health Center in a Rural Area

“…Assessment Tool, 이하 KPCAT)가 개발되었고 [10] 이를 이용하여 일차의료의 질을 측정, 분석한 연구 결 과가 출판된 바 있다 [11][12][13][14][15][16][17][18][19]. Knowledge about the health of community 0 ( 0) 3 3…”

Patient Loyalty in a Mature IDS Market: Is Population Health Management Worth It?

“…The majority of the literature examining factors that predict continuity of primary care relationships is based in settings outside of the United States and relies on patient self‐report of continuity, although this literature consistently finds increased continuity of primary care for those who are female, older, have (more) chronic diseases, and lower education levels (Guthrie ; Mendoza‐Sassi and Beria ; Rosa Filho, Fassa, and Paniz ; Lee et al. ).…”