Entry into primary care and continuity: The effects of access
Entry into primary care and continuity: The effects of access
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DOI：
10.2105/ajph.88.9.1330
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发表时间：
1998-09-01
影响因子：
12.7
通讯作者：
Starfield, B
中科院分区：
文献类型：
--
作者：
Forrest, CB;Starfield, B
目标.本研究探讨了初级保健医生作为第一次接触和连续性与医疗系统的来源之间的关系。从1987年全国医疗费用调查的数据被用来检查使用初级保健医生作为第一次接触的来源，为新的护理事件（逻辑回归），并作为所有门诊访问的连续性来源（多元线性回归）的访问的影响。没有下班后的护理，更长的办公室等待时间和更长的旅行时间减少了与初级保健医生首次接触急性健康问题的机会。较长的预约等待，没有保险，没有下班后的照顾与较低的连续性。全科医生提供更多的第一次接触的护理比专家作为初级保健医生，主要是因为他们更容易获得的做法。这些数据提供了支持之间的联系访问和寻求初级保健医生的护理。
Objectives. This study examined the relationship between access and use of primary care physicians as sources of first contact and continuity with the medical system.Methods. Data from the 1987 National Medical Expenditure Survey were used to examine the effects of access on use of primary care physicians as sources of first contact for new episodes of care (by logistic regression) and as sources of continuity for all ambulatory visits (by multivariate linear regression).Results. No after-hours care, longer office waits, and longer travel times reduced the chances of a first-contact visit with a primary care physician for acute health problems. Longer appointment waits, no insurance, and no after-hours care were associated with lower levels of continuity. Generalists provided more first-contact care than specialists acting as primary care physicians, largely because of their more accessible practices.Conclusions. These data provide support for the linkage between access and care seeking with primary care physicians.