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Patients' Subjective Concepts about Primary Health Care Utilization: a Qualitative Comparative Study Between Norway and Germany

患者对初级卫生保健利用的主观观念：挪威和德国的定性比较研究

基本信息

批准号：
211510595
负责人：
Professor Dr. Wolfram Joachim Herrmann
金额：
--
依托单位：
Division for General Practice
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2012
资助国家：
德国
起止时间：
2011-12-31 至 2014-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/211510595?language=en
关键词：
Patients Subjective Concepts about Primary

项目摘要

In Germany, utilization of ambulatory health care services is high compared to other countries: Whereas a study based on the process data of a large German public health care insurance show in an average 17.9 physician-patient-contacts per year, the comparable figure for Norway is down at about 5. The usual models of health care utilization, such as Rosenstock's Health Belief Model and Andersen's Behavioral Model cannot explain these differences adequately. Organizational factors of the health care system, such as gatekeeping, do not explain the magnitude of the differences.Our hypothesis is that patients' subjective concepts about primary health care utilization play a major role in explaining different health care utilization behavior in different countries. Hence, the aim of this study is to explore these subjective concepts comparatively, exemplary between Germany and Norway.To that aim, we opted for a comparative qualitative study design. In Norway and Germany, we are going to interview 20 patients each with qualitative episodic interviews. In addition, we are going to conduct participant observation in four German and four Norwegian primary care practices. The data is going to be analyzed by thematic coding. By selected categories, we are going to conduct comparative case and group analyses. Thus, we are going to develop a concept and understanding of similarities and differences between the subjective concepts regarding primary health care utilization in Germany and Norway.

在德国，与其他国家相比，门诊医疗服务的利用率较高：根据德国大型公共医疗保险的过程数据进行的一项研究显示，平均每年有17.9名医生与患者接触，而挪威的可比数字则下降到约5人。通常的卫生保健利用模型，如罗森斯托克的健康信念模型和安德森的行为模型不能充分解释这些差异。卫生保健系统的组织因素，如守门人，不能解释差异的大小。我们的假设是，患者对初级卫生保健利用的主观概念在解释不同国家的不同卫生保健利用行为中起着主要作用。因此，本研究的目的是探讨这些主观的概念比较，示范之间的德国和挪威。在挪威和德国，我们将分别对20名患者进行定性情景访谈。此外，我们将在四个德国和四个挪威的初级保健实践中进行参与性观察。数据将通过主题编码进行分析。我们将按选定的类别进行个案和群体比较分析。因此，我们将发展一个概念，并了解德国和挪威初级卫生保健利用的主观概念之间的相似性和差异。