ObjectivesPatients’ experiences are important part of health services quality research, but it’s still unclear whether patients’ experiences are influenced by resident status. This study aimed to evaluate the association between resident status and patients’ primary care experiences with the focus on migrants vs local residents.DesignA cross-sectional study using multistage cluster random sampling was conducted from September to November 2019. The data were analysed using general linear models.SettingSix community health centres in Guangzhou, China.Participants1568 patients aged 20 years or older.Main outcome measuresPatients’ primary care experiences were assessed using the Primary Care Assessment Tool. The 10 domains included in Primary Care Assessment Tool (PCAT) refers to first contact-utilisation, first contact-access, ongoing care, coordination (referral), coordination (information), comprehensiveness (services available), comprehensiveness (services provided), family-centredness, community orientation and cultural competence from patient’s perspective.Results1568 questionnaires were analysed. After adjusting for age, sex, education, annual family income, self-perceived health status, chronic condition, annual medical expenditure and medical insurance, the PCAT total scores of the migrants were significantly lower than those of local residents (β=−0.128; 95% CI −0.218 to −0.037). Migrants had significantly lower scores than local residents in first contact utilisation (β=−0.245; 95% CI −0.341 to −0.148), ongoing care (β=−0.175; 95% CI −0.292 to −0.059), family-centredness (β=−0.112; 95% CI −0.225 to 0.001), community orientation (β=−0.176; 95% CI −0.286 to −0.066) and cultural competence (β=−0.270; 95% CI −0.383 to −0.156), respectively.ConclusionPrimary care experiences of migrants were significantly worse off than those of local residents, especially in terms of primary care utilisation, continuity and cultural competence. Given the wide disparity in primary care experiences between migrants and local residents, Chinese healthcare system reform should focus on improving quality of primary care services for migrants, overcoming language barriers and creating patient-centred primary care services.
Background The goal of this paper was to assess the quality of primary healthcare services at community health centres (CHCs) from the demand (patient) and supplier (healthcare service institution) angles. Methods This study was conducted at six CHCs in the Greater Bay Area of China. Between August and October 2019, 1,568 patients were recruited (55.8% women and 44.2% men). We evaluated the service quality of CHCs using the National Committee for Quality Assurance Patient-Centred Medical Home (NCQA-PCMH) recognition questionnaire. We assessed patients’ experiences with medical and health services using the Primary Care Assessment Tools (PCAT). Results PCAT total and sub-domains scores were significantly difference at the six CHCs (P < 0.001). Among the six CHCs, Shayuan CHC had the highest PCAT total and sub-domain scores and the highest NCQA-PCMH total and sub-domain scores, as well. Older (> 60 years), female, lower education, and employee medical-insured individuals had better patient experiences. Conclusions Our results indicate that CHCs could improve their service quality by improving both institutional health service quality based on NCQA-PCMH assessment and patient experiences based on PCAT scales. These findings can help inform patient-centred primary healthcare policy and management.
Background: To explore the association between the service quality of community health centres (CHCs) as the supplier evaluation and patients’ experiences of health services as the demand-side evaluation.Methods: This study was conducted at six CHCs in the Greater Bay area of China. During August–October 2019, 1568 patients were recruited (55.8% women and 44.2% men). We evaluated the service quality of CHCs using the National Committee for Quality Assurance Patient-Centered Medical Home (NCQA-PCMH) recognition questionnaire. We assessed patients’ experiences with medical and health services using the Primary Care Assessment Tools (PCAT). Results: The global PCAT score was higher at the CHCs with higher NCQA-PCMH levels, showing positive dose-effect trends. This was similar for the PCAT sub-dimensions. For example, the scores of each PCAT sub-dimension of NCQA-PCMH Level 3 were significantly higher than those of Levels 2 and 1. Except for D and F dimensions, the scores of other sub-dimensions of Level 2 were significantly higher than those of Level 1.Conclusions: Our results indicated that better institutional service quality evaluation determined by the NCQA-PCMH led to better patients’ experiences as determined by the PCAT. Our findings added new evidence in support of better institutional primary healthcare service quality leading to better experiences among patients, and would help further improve the patient-centred primary healthcare service policy and management.
Background To explore the association between the service quality of community health centres (CHCs) as the supplier evaluation and patients’ experiences of health services as the demand-side evaluation. Methods This study was conducted at six CHCs in the Greater Bay area of China. During August–October 2019, 1568 patients were recruited (55.8% women and 44.2% men). We evaluated the service quality of CHCs using the National Committee for Quality Assurance Patient-Centered Medical Home (NCQA-PCMH) recognition questionnaire. We assessed patients’ experiences with medical and health services using the Primary Care Assessment Tools (PCAT). Results The global PCAT score was higher at the CHCs with higher NCQA-PCMH levels, showing positive dose-effect trends. This was similar for the PCAT sub-dimensions. For example, the scores of each PCAT sub-dimension of NCQA-PCMH Level 3 were significantly higher than those of Levels 2 and 1. Except for D and F dimensions, the scores of other sub-dimensions of Level 2 were significantly higher than those of Level 1. Conclusions Our results indicated that better institutional service quality evaluation determined by the NCQA-PCMH led to better patients’ experiences as determined by the PCAT. Our findings added new evidence in support of better institutional primary healthcare service quality leading to better experiences among patients, and would help further improve the patient-centred primary healthcare service policy and management.
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