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Integrated care delivery and health care seeking by chronically-ill patients - a case-control study of rural Henan province, China.

Shi L, Makinen M, Lee DC, Kidane R, Blanchet N, Liang H, Li J, Lindelow M, Wang H, Xie S, Wu J - Int J Equity Health (2015)

Bottom Line: Patients in both the Intervention and Control Counties chose their current health care providers primarily out of concern for quality of care (provider expertise and adequate medical equipment) and patient-centered care.Compared with the patients from the Control County, those from the Intervention County performed significantly better on almost all the quality and value of care indicators even after controlling for patients' demographic and health characteristics.Significant associations between types of health care facilities and quality as well as value of care were also observed.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, Maryland, 21205, USA. lshi@jhsph.edu.

ABSTRACT

Objective: This study examined the impact of an Integrated Care Delivery intervention on health care seeking and outcomes for chronically-ill patients in Henan province, China.

Methods: A case-control study was carried out in six health care organizations from two counties in Henan province, China. 371 patients aged 50 years or over with hypertension or diabetes who visited either community health centers or hospitals in the Intervention or Control Counties were systematically selected and surveyed on health care seeking behavior, quality of care, and pathway of care for their major chronic condition. Bivariate analyses were performed to compare quality and value of care indicators between patients from the Intervention and Control Counties. Multivariate analyses were used to confirm these associations after controlling for patients' demographic and health characteristics.

Results: Patients in both the Intervention and Control Counties chose their current health care providers primarily out of concern for quality of care (provider expertise and adequate medical equipment) and patient-centered care. Compared with the patients from the Control County, those from the Intervention County performed significantly better on almost all the quality and value of care indicators even after controlling for patients' demographic and health characteristics. Significant associations between types of health care facilities and quality as well as value of care were also observed.

Conclusion: The study showed that the Integrated Care Delivery Model was critical in guiding patients' health care seeking behavior and associated with improved accessibility, continuity, coordination and comprehensiveness of care, as well as reducing health inequities and mitigating disparities for older patients with chronic conditions.

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Related in: MedlinePlus

Patient satisfaction to current care provider (1–5 Likert Scale). *p < 0.05, **p < 0.01, ***p < 0.001
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Fig3: Patient satisfaction to current care provider (1–5 Likert Scale). *p < 0.05, **p < 0.01, ***p < 0.001

Mentions: The relationship between intervention and patient satisfaction with the current care provider is displayed in Fig. 3. The figure visualizes the satisfaction scores of 13 indicators reported by patients from Intervention vs. Control Counties on a scale of 1 to 5 with 1 indicating least satisfied and 5 most satisfied. From this figure, it is apparent that patients from the Intervention County reported significantly higher score in all indicators (all the measures are at or above 4.50) than those in the Control County. Particularly, the most notable differences of scores between subjects from the Intervention and Control Counties were insurance requirement (4.68 vs. 3.97, p < 0.001), out-of-office hours (4.64 vs. 3.97, p < 0.001) and out-of-pocket money (4.50 vs. 3.84, p < 0.001).Fig. 3


Integrated care delivery and health care seeking by chronically-ill patients - a case-control study of rural Henan province, China.

Shi L, Makinen M, Lee DC, Kidane R, Blanchet N, Liang H, Li J, Lindelow M, Wang H, Xie S, Wu J - Int J Equity Health (2015)

Patient satisfaction to current care provider (1–5 Likert Scale). *p < 0.05, **p < 0.01, ***p < 0.001
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4663729&req=5

Fig3: Patient satisfaction to current care provider (1–5 Likert Scale). *p < 0.05, **p < 0.01, ***p < 0.001
Mentions: The relationship between intervention and patient satisfaction with the current care provider is displayed in Fig. 3. The figure visualizes the satisfaction scores of 13 indicators reported by patients from Intervention vs. Control Counties on a scale of 1 to 5 with 1 indicating least satisfied and 5 most satisfied. From this figure, it is apparent that patients from the Intervention County reported significantly higher score in all indicators (all the measures are at or above 4.50) than those in the Control County. Particularly, the most notable differences of scores between subjects from the Intervention and Control Counties were insurance requirement (4.68 vs. 3.97, p < 0.001), out-of-office hours (4.64 vs. 3.97, p < 0.001) and out-of-pocket money (4.50 vs. 3.84, p < 0.001).Fig. 3

Bottom Line: Patients in both the Intervention and Control Counties chose their current health care providers primarily out of concern for quality of care (provider expertise and adequate medical equipment) and patient-centered care.Compared with the patients from the Control County, those from the Intervention County performed significantly better on almost all the quality and value of care indicators even after controlling for patients' demographic and health characteristics.Significant associations between types of health care facilities and quality as well as value of care were also observed.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, Maryland, 21205, USA. lshi@jhsph.edu.

ABSTRACT

Objective: This study examined the impact of an Integrated Care Delivery intervention on health care seeking and outcomes for chronically-ill patients in Henan province, China.

Methods: A case-control study was carried out in six health care organizations from two counties in Henan province, China. 371 patients aged 50 years or over with hypertension or diabetes who visited either community health centers or hospitals in the Intervention or Control Counties were systematically selected and surveyed on health care seeking behavior, quality of care, and pathway of care for their major chronic condition. Bivariate analyses were performed to compare quality and value of care indicators between patients from the Intervention and Control Counties. Multivariate analyses were used to confirm these associations after controlling for patients' demographic and health characteristics.

Results: Patients in both the Intervention and Control Counties chose their current health care providers primarily out of concern for quality of care (provider expertise and adequate medical equipment) and patient-centered care. Compared with the patients from the Control County, those from the Intervention County performed significantly better on almost all the quality and value of care indicators even after controlling for patients' demographic and health characteristics. Significant associations between types of health care facilities and quality as well as value of care were also observed.

Conclusion: The study showed that the Integrated Care Delivery Model was critical in guiding patients' health care seeking behavior and associated with improved accessibility, continuity, coordination and comprehensiveness of care, as well as reducing health inequities and mitigating disparities for older patients with chronic conditions.

Show MeSH
Related in: MedlinePlus