Capturing What Matters with Patients’ Bypass Behavior? Evidence from a Cross-Sectional Study in China

作者：Wenwen Xie, Jiayuan Liu, Yuankai Huang, Xiaoyu Xi · 发表于：Patient Preference and Adherence · 年份：2023 · DOI：10.2147/ppa.s395928 · 被引用次数：16 · 研究领域：Patient Satisfaction in Healthcare、Primary Care and Health Outcomes、Healthcare Systems and Reforms

Background: In China, bypassing is becoming increasingly prevalent. Such behavior, as going directly to upper-level health-care facilities without a primary care provider (PCP) referral when facing non-critical diseases, contrasts to "expanding the role of PCPs as the first-contact of care", may cause unneglectable damage to the healthcare system and people's physical health. Objective: To examine the relationship between patient experience in primary health-care clinics (PHCs) and their bypass behavior. Methods: to gather information, using a convenience sampling. The primary independent variable was scores measured by Chinese Primary Care Assessment Tool (PCAT-C) to quantify patients' experience at PHCs. The dependent variable was a binary variable measured by a self-developed instrument to identify whether participants actually practiced bypassing. Covariates were well-screened determinants of patients' bypass behavior including socio-demographic factors, policy factors, and health-care suppliers. Binary logistic regression analysis was employed to evaluate the association of patients' experience with their bypass behavior. Findings: A total of 928 qualified questionnaires were obtained. The first contact dimension (OR 0.961 [95% CI 0.934 to 0.988], P = 0.005) and continuity dimension (OR 1.034 [95% CI 1.000 to 1.068], P = 0.047) of patients' experience were significantly associated with patients' bypass behavior (P < 0.05). In addition, age (OR 1.072, [95% CI 1.015-1.132]...