Usual source of care and the quality of primary care: a survey of patients in Guangdong province, China

Du, Zhicheng; Liao, Yu; Chen, Chien‐Chou; Hu, Ruwei

doi:10.1186/s12939-015-0189-4

Cited by 27 publications

(29 citation statements)

References 25 publications

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“…It suggested that doctors would not seek advice from patients or their family members when making treatment plans. This finding was in line with several previous studies [33][34][35]. Though many experts called for more autonomy and participation for patients, it was difficult for patients to achieve equality in their medical decisions due to insufficient medical knowledge or communication barriers [13,36].…”

Section: Discussionsupporting

confidence: 91%

Comparison of Patients’ Perceived Quality of Primary Care Between Urban and Rural Community Health Centers in Guangdong, China

chen

Feng

Zhang

et al. 2020

Preprint

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Background: A series of reforms were implemented to improve the quality of primary care services in China. This study aims to assess patients' perceived quality of primary health care between rural and urban community health centers in Guangdong.Methods: A cross-sectional survey was conducted from July to December 2015 in Guangdong. We surveyed 1010 respondents who visited either CHCs/CHSs in urban areas or THCs/RHSs in rural areas via face-to-face interviews. A validated Chinese version of Primary Care Assessment Tool-Adult Short Version (PCAT-AS), representing 10 primary care domains, was used to collect information on patients’ primary care experiences. T-test was used for comparison on domain scores and total scores between patients from CHCs/CHSs and THCs/RHSs. Analysis of covariance was employed to compare the adjusted PCAT domain scores and total scores. Multilevel models were used to explore factors associated with PCAT total scores. Results: Overall, patients reported a lower level of experience of community orientation and family centeredness compared to other primary care domains. Patients from THCs/RHSs settings in the rural area reported better primary care experience in four domains, including first contact, accessibility, ongoing care, and community orientation. Higher education background, and those with a chronic disease were associated with better primary care experience, after controlling for confounding factors. Patients who preferred primary care institutions when getting sick or used health services more frequently reported better primary care experience.Conclusion: Continued efforts are needed to strengthen primary care performance, particularly in community orientation and family centeredness. Primary care delivery in CHCs/CHSs settings should be improved in four domains including first contact, accessibility, ongoing care, and community orientation.

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Section: Discussionsupporting

confidence: 91%

Comparison of Patients’ Perceived Quality of Primary Care Between Urban and Rural Community Health Centers in Guangdong, China

chen

Feng

Zhang

et al. 2020

Preprint

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“…Limitations of the study include: 1- the definition of the outcome variable – USC – refers to a provider or place a patient consult when sick or in need of medical advice and is considered one of the hallmarks of primary health care [5]. Furthermore, USC is used in many self-reported surveys and is operationalized through questions such as “Is there one particular place that you go if you are sick or need advice about your health?” and “Is there a regular doctor you usually see at this place?” [8, 9].…”

Section: Discussionmentioning

confidence: 99%

The effect of the Family Health Strategy on usual source of care in Brazil: data from the 2013 National Health Survey (PNS 2013)

Dourado

Medina

Aquino

2016

Int J Equity Health

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BackgroundA usual source of care (USC) has been conceptualized as having a health provider or place available for patients to consult when sick or in need of medical care. Having a USC is a means to achieve longitudinality of care with Primary Health Care (PHC) providers. Brazil has made enormous progress in PHC and thus provides an important opportunity to investigate USC in a middle-income country context.MethodsThis study uses data from a nationally representative household survey, the 2013 National Health Survey (n = 62,986), to describe the prevalence of having a USC in Brazil and to investigate to what extent the Family Health Strategy (FHS) has contributed to USC prevalence. Analyses include descriptive, bivariate and multivariable Poisson regression.ResultsShow very high rates of people reporting any type of USC (74.4 %) and more than one third reporting PHC as their USC. Household enrolment in the FHS was positively associated with having any USC (PR:1.09; 95 % CI: 1.07–1.12) and a stronger association with having PHC as the regular source of care (PR:1.63;95 % CI:1.54–1.73). FHS enrolment was negatively associated with reporting emergency/urgent care facilities as one’s USC (PR: 0.67; 95 % CI: 0.59–0.76). The association between the more consolidated FHS with having a USC was strongest in the poorest regions of the country (North, Northeast and Central-West). Having PHC as one’s USC showed a positive dose-response relationship with the FHS in all regions, especially in the Central-West.ConclusionsOur results have important implications for the health care model in Brazil and in other countries, especially those seeking to base their national health systems more strongly on primary health care. The study suggests expanding primary health care can increase the establishment of a USC which can help assure better monitoring of chronic conditions and attention to patient needs.

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“…” A growing body of research indicates that having a USC improves timely access to medical care, improves quality of care received, and results in improved health status (23456). Primary care can be identified as the specific set of health care functions served by a USC.…”

Section: Introductionmentioning

confidence: 99%

Having a Physician Rather than a Place as a Usual Source of Care Would Be Better - from 2012 Korea Health Panel Data

2017

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A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC. Adjusted odds ratios (ORs) of having a physician with a place compared to not having a USC were 4.05 for age 65 ≥ years (vs. < 35 years), 1.33 for females (vs. males), 0.63 for the fifth (highest) quintile (vs. the first) of household income, 1.62 for medical aid (vs. employee) health insurance, and 4.46 for having a chronic disease (vs. not). For those having a physician with a place (vs. only a place) as a USC, adjusted ORs of hospital admission and emergency room (ER) visit were 0.77 and 0.71 with out-of-pocket costs not significantly high. Those having a physician with a place (vs. only a place) as a USC included more patients with chronic diseases, but they had fewer hospital admissions and ER visits. When designing a plan for health care reform in Korea, promoting having a physician rather than a place as a USC would be a better policy.

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Usual source of care and the quality of primary care: a survey of patients in Guangdong province, China

Cited by 27 publications

References 25 publications

Comparison of Patients’ Perceived Quality of Primary Care Between Urban and Rural Community Health Centers in Guangdong, China

Comparison of Patients’ Perceived Quality of Primary Care Between Urban and Rural Community Health Centers in Guangdong, China

The effect of the Family Health Strategy on usual source of care in Brazil: data from the 2013 National Health Survey (PNS 2013)

Having a Physician Rather than a Place as a Usual Source of Care Would Be Better - from 2012 Korea Health Panel Data

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