Background: Patients' experience is a critical aspect for evaluating the quality of primary care services. However, research on patient experience in China started relatively late, with limited focus on patients in primary care facilities.
Objective: To reflect the status of primary care services in China based on the experience of patients visiting primary care facilities.
Methods: From March to April 2023, a cross-sectional survey was conducted using intercept sampling in 12 national pilot zones for primary healthcare reform. Investigators, trained in survey techniques, administered the Assessment Survey of Primary Care (ASPC) scale to 1,157 patients at 36 primary care facilities, including township health centers and community health centers.
Results: The average scores for five dimensions were: 69.5±20.5 for first visit/first-line care, 74.1±20.1 for service accessibility, 72.0±20.7 for continuity of doctor-patient relationships, 75.1±21.0 for comprehensive services, and 68.5±21.7 for coordinated services. The overall ASPC score was 71.8±17.3. Significant differences (P<0.05) were found based on age, education level, employment status, family doctor enrollment, self-reported chronic conditions and pilot zone. Multivariate regression analysis identified age, employment status, family doctor enrollment, and pilot zone as significant influencing factors for scores in various dimensions. Unemployed patients scored lower across all dimensions compared to employed patients (P < 0.05). Patients with a family doctor contract had higher scores across all dimensions compared to those without a contract (P < 0.05). Significant regional differences in scores were found, with higher scores in Changting and Xishui counties compared to Jiexiu city (P < 0.05), and lower scores in Haiyan, Lu, and Dongfang cities compared to Jiexiu (P < 0.05).
Conclusion: The ASPC scale effectively reflects the current state of primary care services in China. The family doctor contracted services improve patient experiences in primary care facilities, particularly in the dimensions of accessibility, doctor-patient continuity, and coordination. Regional variations in patient experiences are linked to “patient-centered” approaches and convenience measures.
Authors' contributions
Conceptualization, Q.J.; Methodology, L.C., Z.Y., Z.L. and Q.J.; Data curation, L.C. and L.S.; Formal analysis, L.C. and L.S.; Funding acquisition, Q.J.; Investigation, L.C., Z.Y., Z.L.; Methodology, Q.J., L.C., Project administration, Q.J., Z.Y., Z.L.; Resources, L.C., Z.Y., Z.L; Supervision, Q.J.; Validation, Q.J.; Writing—original draft, L.C.;4;review and editing, L.S. All authors have read and agreed to the published version of the manuscript.
Authors' other information
Not applicable.
Ethical approval and consent to participate
Not applicable.
Consent for publication
Not applicable.
Availability of data and materials
Not applicable.
Funding
Not applicable.
Declaration of competing interest
Q.J. is the editor of Chinese General Practice Journal, she is not envolved in the editorial review or the decision to publish this article. All authors declare that there are no competing interests.
Acknowledgements
Not applicable.
| [1] |
Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013; 3(1):e001570. doi: 10.1136/bmjopen-2012-001570.
|
| [2] |
Li L, Kuang L, Zhong CW. Development of the Chinese version of the core features and functions of primary care patient experience scale. (Chinese). Chin Gen Pract. 2021; 24(13):1629-1636. doi: 10.12114/j.issn.1007-9572.2020.00.497.
|
| [3] |
Kuang L, Li L, Luo ZJ, et al. Development and validation of the Chinese version of the core features and functions of primary care patient experience scale. (Chinese). Chin Gen Pract. 2021; 24(13):1621-1628 1643. doi: 10.12114/j.issn.1007-9572.2020.00.496.
|
| [4] |
Zhao R. The World Health Report 2008: Primary health Care —Now More Important Than ever. (Chinese). Beijing: People’s Medical Publishing House; 2008.
|
| [5] |
WONCA Europe. The European definition of General Practice/Family Medicine. Barcelona: WONCA Europe; 2002.
|
| [6] |
Peng YC, Wang Y, Chang WH, et al. Study on the quality evaluation index system for general practice. (Chinese). Chin Gen Pract. 2004; 7(3):158-160. doi: 10.3969/j.issn.1007-9572.2004.03.010.
|
| [7] |
Luo XL, Huang YL, Hao J, et al. Research on the construction of an evaluation index system for family doctor team contracted service capacity. (Chinese). Chin Gen Pract. 2019; 22(13):1554-1558. doi: 10.12114/j.issn.1007-9572.2019.00.216.
|
| [8] |
Wang F. Family doctor contracted services: Opening the path for high-quality development. (Chinese). China Health. 2022(5):66-68. doi: 10.15973/j.cnki.cn11-3708/d.2022.05.024.
|
| [9] |
Wang X, Zhang YC, Qin JM, et al. Impact of family doctor contracted services on the core characteristics of general practice in Ningbo City. (Chinese). Soft Sci Health. 2023; 37(4):51-55. doi: 10.3969/j.issn.1003-2800.2023.04.013.
|
| [10] |
Wang X, Zhang YC, Qin JM, et al. Impact of core characteristics of general practice on patient satisfaction with visits under the family doctor contracted service model: A case study of J County in Henan Province. (Chinese). Chin Prim Health Care. 2023; 37(1):22-25. doi: 10.3969/j.issn.1001-568X.2023.01.0007.
|
| [11] |
Yang JH, Zhou MP, Liang CY, et al. Impact of family doctor contracted services on the core characteristics of general practice in urbanized areas of the Pearl River Delta. (Chinese). Chin J Soc Med. 2021; 38(4):441-445.
|
| [12] |
Fu XL, Zhang K, Chen XF, et al. The National Mental Health Development Report of China (2019-2020). (Chinese). Beijing: Social Sciences Academic Press; 2021.
|
| [13] |
Hu GY, Liu YL. Concept and evaluation practice of patient experience in medical services. (Chinese). Chin J Health Pol. 2019; 12(3):24-31. doi: 10.3969/j.issn.1674-2982.2019.03.004.
|
PDF
(497KB)
