The availability of local primary care services, satisfaction with health services and self-rated health in older English adults: A population-based study.
The availability of local primary care services, satisfaction with health services and self-rated health in older English adults: A population-based study.
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DOI：
10.1016/j.pmedr.2022.101786
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发表时间：
2022-06
影响因子：
2.8
通讯作者：
Matthews, Fiona
中科院分区：
文献类型：
--
作者：
Wu, Yu-Tzu;Prina, Matthew;Matthews, Fiona
关键词：
初级保健服务可以在解决健康不平等和人口老龄化挑战方面发挥重要作用。本研究的目的是调查当地初级保健服务的可用性是否可以支持老年人对卫生服务和自我评价健康的满意度。这项研究基于一项基于人群的队列研究，理解社会：英国家庭纵向研究，重点关注英格兰第3波（2011-2013; N = 14498）和第6波（2014-2016; N = 13025）年龄≥ 50岁的人群。初级保健服务的位置，包括全科医生（GP）诊所和其他社区卫生服务，是从国家卫生服务数字中确定的，并与研究参与者的住宅区相关联。多层次泊松回归模型被用来调查当地初级保健服务的可用性，对卫生服务的满意度和自我评估的健康调整社会人口因素，贫困和城市/农村环境之间的关联。在当地有更多全科医生实践的参与者不太可能报告对第3波（IRR：0.67; 95% CI：0.52，0.85）和第6波（IRR：0.74; 95% CI：0.59，0.92）卫生服务的不满。在这两个波中没有发现与自测健康的关联。这些关联在不同的贫困程度和城乡环境中是相似的。研究结果表明，增加当地初级保健服务的可用性可能会提高老年人的满意度，但不会改善老年人的健康状况。为了优化初级保健服务在健康老龄化中的支持作用，未来的研究应确定老年人对健康和社会保健的复杂需求及其使用服务的经验。
Primary care services can play an important role in addressing health inequalities and challenges of population ageing. The aim of this study is to investigate whether the availability of local primary care services can support satisfaction with health services and self-rated health in older people. This study was based on a population-based cohort study, Understanding Society: the UK Household Longitudinal Study, focusing on people aged ≥ 50 at Wave 3 (2011–2013; N = 14498) and Wave 6 (2014–2016; N = 13025) in England. Locations of primary care services, including general practitioner (GP) practices and other community health services, were identified from National Health Service Digital and linked to residential areas of the study participants. Multilevel Poisson regression modelling was used to investigate the associations between the availability of local primary care services, satisfaction with health services and self-rated health adjusting for sociodemographic factors, deprivation and urban/rural settings. Participants who had more GP practices in local areas were less likely to report dissatisfaction with health services in Wave 3 (IRR: 0.67; 95% CI: 0.52, 0.85) and Wave 6 (IRR: 0.74; 95% CI: 0.59, 0.92). No associations with self-rated health were found in both waves. These associations were similar across deprivation levels and urban/rural settings. The results suggest that increasing availability of local primary care services may improve satisfaction but not health in older people. To optimise the supportive role of primary care services in healthy ageing, future research should identify complex needs of health and social care in older people and their experience of using the services.
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