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首页> 外文期刊>Health services research: HSR >GP GP Practices as a One‐Stop Shop: How Do Patients Perceive the Quality of Care? A Cross‐Sectional Study in Thirty‐Four Countries
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GP GP Practices as a One‐Stop Shop: How Do Patients Perceive the Quality of Care? A Cross‐Sectional Study in Thirty‐Four Countries

机译：GP GP实践作为一站式商店：患者如何感知护理质量？ 三十四个国家的横断面研究

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Objective To contribute to the current knowledge on how a broad range of services offered by general practitioners ( GP s) may contribute to the patient perceived quality and, hence, the potential benefits of primary care. Study Setting Between 2011 and 2013, primary care data were collected among GP s and their patients in 31 European countries, plus Australia, Canada, and New Zealand. In these countries, GP s are the main providers of primary care, mostly specialized in family medicine and working in the ambulatory setting. Study Design In this cross‐sectional study, questionnaires were completed by 7,183 GP s and 61,931 visiting patients. Moreover, 7,270 patients answered questions about what they find important (their values). In the analyses of patient experiences, we adjusted for patients’ values in each country to measure patient perceived quality. Perceived quality was measured regarding five areas: accessibility and continuity of care, doctor–patient communication, patient involvement in decision making, and comprehensiveness of care. The range of GP services was measured in relation to four areas: (1) to what extent they are the first contact to the health care system for patients in need of care, (2) their involvement in treatment and follow‐up of acute and chronic conditions, in other words treatment of diseases, (3) their involvement in minor technical procedures, and (4) their involvement in preventive treatments. Extraction Methods Data of the patients were linked to the data of the GP s. Multilevel modeling was used to construct scale scores for the experiences of patients in the five areas of quality and the range of services of GP s. In these four‐level models, items were nested within patients, nested in GP practices, nested in countries. The relationship between the range of services and the experiences of patients was analyzed in three‐level multilevel models, also taking into account the values of patients. Principal Findings In countries where GP s offer a broader range of services patients perceive better accessibility, continuity, and comprehensiveness of care, and more involvement in decision making. No associations were found between the range of services and the patient perceived communication with their GP . The range of GP services mostly explained the variation between countries in the areas of patient perceived accessibility and continuity of care. Conclusions This study showed that in countries where GP practices serve as a “one‐stop shop,” patients perceive better quality of care, especially in the areas of accessibility and continuity of care. Therefore, primary care in a country is expected to benefit from investments in a broader range of services of GP s or other primary care physicians.
机译：目的为目前关于全科医生（GP S）提供的广泛服务的知识可能会有助于患者感知质量，从而为初级保健的潜在利益贡献。 2011年至2013年期间的学习环境，在31个欧洲国家，加上澳大利亚，加拿大和新西兰的GP S及其患者之间收集了初级保健数据。在这些国家，GP S是初级保健的主要供应商，主要是专门从事家庭医学，并在动态环境中工作。研究设计在这个横断面研究中，问卷由7,183 GP S和61,931名患者完成。此外，7,270名患者回答了他们认为重要的问题（他们的价值观）。在分析患者体验中，我们调整了每个国家的患者价值，以衡量患者的感知质量。衡量了五个方面的感知质量：护理的可访问性和连续性，医生沟通，患者参与决策，以及综合性护理。 GP服务的范围是关于四个方面测量的：（1）他们是针对需要护理的患者的医疗保健系统的第一次接触，（2）他们参与治疗和随访的急性和后续行动慢性病，换句话说，疾病治疗，（3）他们参与次要的技术程序，（4）他们参与预防治疗。提取方法患者的数据与GP S的数据相关联。多级建模用于构建患者在五个质量领域和GP S服务范围内的患者体验分数。在这四级模型中，物品嵌套在患者内，嵌套在GP实践中，嵌套在国家。在三级多级模型中分析了服务范围与患者经验之间的关系，同时考虑了患者的价值。 GP S提供更广泛的服务患者的国家的主要发现感知为照顾的更好的可访问性，连续性和全面性，以及更多地参与决策。在服务范围和患者与其GP的沟通之间没有发现任何关联。 GP服务范围主要解释了各国在患者感知的可访问性和关心连续性方面的变化。结论本研究表明，在GP实践作为“一站式商店”的国家，患者会感知更好的护理质量，特别是在护理的可访问性和连续性方面。因此，预计一个国家的初级保健将从投资中受益于GP S或其他初级保健医生的更广泛的服务。

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