Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery system
IntroductionThe hierarchical healthcare delivery system is an important measure to improve the allocation of medical resources and promote equitable distribution of basic medical and health services. It is one of the key factors in the success or failure of China’s medical reform. This study aims to...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1326272/full |
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| author | Lizhu Guo Lizhu Guo Xin Du Huanqi Wu Shijun Xia Jing Du Xiangrong Kong Xiaohui Yang Chi Wang Jianzeng Dong Changsheng Ma Lilly Engineer Lilly Engineer |
| author_facet | Lizhu Guo Lizhu Guo Xin Du Huanqi Wu Shijun Xia Jing Du Xiangrong Kong Xiaohui Yang Chi Wang Jianzeng Dong Changsheng Ma Lilly Engineer Lilly Engineer |
| author_sort | Lizhu Guo |
| collection | DOAJ |
| description | IntroductionThe hierarchical healthcare delivery system is an important measure to improve the allocation of medical resources and promote equitable distribution of basic medical and health services. It is one of the key factors in the success or failure of China’s medical reform. This study aims to analyze the factors influencing patients’ healthcare-seeking behaviors, including socioeconomic and clinical outcomes, under China’s hierarchical healthcare delivery system, and to provide potential solutions.MethodsPatients receiving outpatient treatment in the past 14 days and inpatient care in the past 1 year were investigated. The multivariate logistic regression was used to analyze the influencing factors of patient’s medical treatment behavior selection, and to compare whether the clinical outcomes of primary medical institutions and grade A hospitals are the same.ResultsNine thousand and ninety-eight person-times were included in the study. Of these, 4,538 patients were outpatients, 68.27% of patients were treated in primary medical institutions; 4,560 patients were hospitalized, 58.53% chose to be hospitalized in grade A hospitals. Provinces and cities, urban and rural areas, occupation, education level, medical insurance type, income, whether there are comorbid diseases, and doctors’ medical behavior are the factors affecting the choice of medical treatment behavior. Patients who choose primary medical institutions and grade A hospitals have different control levels and control rate for the blood pressure, blood lipids, blood glucose.ConclusionUnder the hierarchical diagnosis and treatment system, the patients’ choice of hospital is mainly affected by their level of education, medical insurance types, and the inpatients are also affected by whether there are comorbid conditions. Clinical outcomes of choosing different levels of hospitals were different. |
| first_indexed | 2024-04-24T10:51:08Z |
| format | Article |
| id | doaj.art-81bb6de5df204fc5ace710727f821e30 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-24T10:51:08Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-81bb6de5df204fc5ace710727f821e302024-04-12T11:57:50ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-04-011210.3389/fpubh.2024.13262721326272Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery systemLizhu Guo0Lizhu Guo1Xin Du2Huanqi Wu3Shijun Xia4Jing Du5Xiangrong Kong6Xiaohui Yang7Chi Wang8Jianzeng Dong9Changsheng Ma10Lilly Engineer11Lilly Engineer12Department of Arrhythmia Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Arrhythmia Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaData Science Academy, Capital University of Economics and Business, Beijing, ChinaDepartment of Arrhythmia Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaBeijing Centre for Disease Prevention and Control, Beijing, ChinaWilmer Eye Institute, School of Medicine, Johns Hopkins University, Baltimore, MD, United StatesDepartment of Arrhythmia Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaHeart Health Research Centre, Beijing, ChinaDepartment of Arrhythmia Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Arrhythmia Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, ChinaDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United StatesDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United StatesIntroductionThe hierarchical healthcare delivery system is an important measure to improve the allocation of medical resources and promote equitable distribution of basic medical and health services. It is one of the key factors in the success or failure of China’s medical reform. This study aims to analyze the factors influencing patients’ healthcare-seeking behaviors, including socioeconomic and clinical outcomes, under China’s hierarchical healthcare delivery system, and to provide potential solutions.MethodsPatients receiving outpatient treatment in the past 14 days and inpatient care in the past 1 year were investigated. The multivariate logistic regression was used to analyze the influencing factors of patient’s medical treatment behavior selection, and to compare whether the clinical outcomes of primary medical institutions and grade A hospitals are the same.ResultsNine thousand and ninety-eight person-times were included in the study. Of these, 4,538 patients were outpatients, 68.27% of patients were treated in primary medical institutions; 4,560 patients were hospitalized, 58.53% chose to be hospitalized in grade A hospitals. Provinces and cities, urban and rural areas, occupation, education level, medical insurance type, income, whether there are comorbid diseases, and doctors’ medical behavior are the factors affecting the choice of medical treatment behavior. Patients who choose primary medical institutions and grade A hospitals have different control levels and control rate for the blood pressure, blood lipids, blood glucose.ConclusionUnder the hierarchical diagnosis and treatment system, the patients’ choice of hospital is mainly affected by their level of education, medical insurance types, and the inpatients are also affected by whether there are comorbid conditions. Clinical outcomes of choosing different levels of hospitals were different.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1326272/fullpatients’ healthcare-seeking behavioroutcomeshierarchical healthcare delivery systemcardiovascular risk factorsprimary healthcare |
| spellingShingle | Lizhu Guo Lizhu Guo Xin Du Huanqi Wu Shijun Xia Jing Du Xiangrong Kong Xiaohui Yang Chi Wang Jianzeng Dong Changsheng Ma Lilly Engineer Lilly Engineer Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery system Frontiers in Public Health patients’ healthcare-seeking behavior outcomes hierarchical healthcare delivery system cardiovascular risk factors primary healthcare |
| title | Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery system |
| title_full | Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery system |
| title_fullStr | Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery system |
| title_full_unstemmed | Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery system |
| title_short | Factors associated with patients’ healthcare-seeking behavior and related clinical outcomes under China’s hierarchical healthcare delivery system |
| title_sort | factors associated with patients healthcare seeking behavior and related clinical outcomes under china s hierarchical healthcare delivery system |
| topic | patients’ healthcare-seeking behavior outcomes hierarchical healthcare delivery system cardiovascular risk factors primary healthcare |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1326272/full |
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