Primary care quality: Community health center and health maintenance organization
Primary care quality: Community health center and health maintenance organization
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DOI：
10.1097/01.smj.0000066811.53167.2e
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发表时间：
2003-08-01
影响因子：
1.1
通讯作者：
Regan, J
中科院分区：
文献类型：
--
作者：
Shi, LY;Starfield, B;Regan, J
目的：比较南卡罗来纳州社区卫生中心(CHCs)和卫生维护组织(HMOS)的初级卫生保健质量，以阐明社区卫生中心与卫生维护组织等主流机构相比的初级卫生保健服务质量。方法：通过邮件调查随机选择350名HMO用户。调查和后续访谈从540名随机选择的CHC用户中获得了数据。在两次调查中都使用了经过验证的成人初级保健评估工具。结果：在控制了社会人口学和卫生保健使用措施后，CHC患者在几个初级保健领域(持续护理、服务协调、综合性和社区导向)以及总体初级保健表现上表现出更高的得分。结论：CHC使用者比HMO使用者更有可能评价他们的初级保健提供者良好，除了在第一次接触容易的领域。考虑到许多CHC使用者具有与较差的护理评级相关的特征，CHC的正面评级尤其令人印象深刻。
Objective: This study compares the primary health care quality of community health centers (CHCs) and health maintenance organizations (HMOs) in South Carolina to elucidate the quality of CHC performance relative to mainstream settings such as the HMO.Methods: Mail surveys were used to obtain data from 350 randomly selected HMO users. Surveys with follow-up interviews were conducted to obtain data from 540 randomly selected CHC users. A validated adult primary care assessment tool was used in both surveys. Multivariate analyses were performed to assess the association of health care setting (HMO versus CHC) with primary care quality while controlling for sociodemographic and health care characteristics.Results: After controlling for sociodemographic and health care use measures, CHC patients demonstrated higher scores in several primary care domains (ongoing care, coordination of service, comprehensiveness, and community orientation) as well as total primary care performance.Conclusion: Users of CHC are more likely than HMO users to rate their primary health care provider as good, except in the area of ease of first contact. The positive rating of the CHC is particularly impressive after taking into account that many CHC users have characteristics associated with poorer ratings of care.