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Impact of the hierarchical medical system on the perceived quality of primary care in China:a quasi-experimental study 认领 引用 被引量：2
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作者 Yaxin Zhao Xiaohui Zhai +5 位作者 Zhongliang Zhou Zixuan Peng Chi Shen Xiaojing Fan Sha Lai Peter C.Coyte 《Global Health Research and Policy》 CSCD 2025年第1期669-679,共11页
Background Although the implementation of a hierarchical medical system(HMS)has been shown to improve the allocation of medical resources and patient health-seeking behaviour,its role in patient's perceived qualit... Background Although the implementation of a hierarchical medical system(HMS)has been shown to improve the allocation of medical resources and patient health-seeking behaviour,its role in patient's perceived quality of primary care remains unexplored.This study aimed to assess the impact of HMS implementation on rural and urban residents'perceived quality of primary care.Methods Data were obtained from the China Family Panel Study for 2012,2014,2016,and 2018.A total of 40,011 rural and 22,482 urban residents were included in the research participants for analysis.This study adopted a quasi-natural experimental design,and the multiple-period difference-in-differences method was used to capture changes in patient's perceived quality of primary care before and after the introduction of HMS.Results We found that HMS implementation declined the perceived quality of primary care by an average of 18%among rural residents(OR:0.82,95%CI 0.68-0.99),while there was no significant change among urban residents(OR:1.13,95%CI 0.87-1.46).There was a 24%reduction in the perceived quality of primary care(OR:0.76,95%CI 0.61-0.96)one year after HMS among rural residents,and there was no statistically significant difference two years after HMS.After HMS implementation,the level of perceived quality of primary care by rural patients with chronic diseases decreased by 72%(OR:0.28,95%CI 0.11-0.78).Conclusions HMS has a limited effect on improving residents'perceived quality of primary care,especially for those living in rural areas.Policymakers are suggested to establish a quality monitoring system that incorporates patient experience as an essential standard to systematically evaluate the impacts of the HMS,with more efforts being put into helping vulnerable groups such as residents under 60 years old and patients with chronic diseases. 展开更多
关键词 Primary care Patients'perceived quality Difference-in-differences Hierarchical medical system China
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老年PCI后患者自我管理行为现状及影响因素研究 认领 引用 被引量：1
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作者 赵晓晓 罗艳艳 《现代医药卫生》 2024年第22期3893-3898,共6页
目的探讨老年经皮冠状动脉介入治疗(PCI)术后患者自我管理行为与自我调节疲劳、患者感知赋权的情况进行调查及其关系,以提高医护人员对老年冠心病患者自我管理行为的关注程度,从而对老年PCI术后患者进行有针对性的护理干预。方法采用便... 目的探讨老年经皮冠状动脉介入治疗(PCI)术后患者自我管理行为与自我调节疲劳、患者感知赋权的情况进行调查及其关系,以提高医护人员对老年冠心病患者自我管理行为的关注程度,从而对老年PCI术后患者进行有针对性的护理干预。方法采用便利抽样方法选取2022年3月至2023年6月河南省某三甲医院住院的老年PCI术后患者324例作为研究对象,使用一般资料调查表、冠心病自我管理行为量表(CS-MS)、自我调节疲劳量表、患者感知赋权量表等工具调查患者的自我管理行为、自我调节疲劳、感知赋权水平等。采用SPSS26.0统计软件进行数据分析。结果324例患者自我管理行为处于中等水平。CS-MS得分与患者感知赋权量表得分呈显著正相关,与自我调节疲劳量表得分呈显著负相关,差异均有统计学意义(r=0.404、-0.364,P<0.001)。患者感知赋权、自我调节疲劳、文化程度、居住地、支架植入数均可影响其自我管理行为,可以共同解释因变量CS-MS得分的30.40%的变异量。结论老年PCI术后患者自我管理行为和患者感知赋权处于中等水平,且存在较明显的自我调节疲劳;文化程度、居住地、支架植入数、自我调节疲劳、感知赋权等均是老年PCI术后患者自我管理行为的影响因素。 展开更多
关键词 老年人 自我管理行为 自我调节疲劳 患者感知赋权
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