Patient Experience In Four Models Of Community Health Service Centers In Xi'an

Objective:China's ageing population,coupled with the prevalence of chronic diseases,has increased the national health burden.Experience in developed countries shows that the use of primary health care resources can effectively address these problems.However,the three-level referral system in China is not perfect,and patients have poor medical experience of basic health care service institutions,thus reducing the function of primary health care institutions.Therefore,the study of patient experience in primary health care institutions can effectively find the shortcomings and strengths of medical services and help to propose targeted reform measures.At present,there are many community health service centers with different management and operation modes in Xi'an,and there is no relevant data on the service quality comparison from the perspective of patient experience.By studying the patient experience of community health service centers with different operation modes,we can find out the excellent management mechanism and provide reference for accelerating the reform of primary health care institutions.Methods:the Chinese version of the Primary Care Assessment Tool that was integrated and revised based on the expert opinions and preliminary survey results,which based on the literature review and the collection.Using the scale in Xi"an urban area with convenient sampling method for survey 250 clinic patients in each four community health service centres(Community health service center outside the hospital run by tertiary hospitals?community health service center run by enterprises?The traditional community health service center?community health service center within the hospital run by tertiary hospitals)on June 12to August 11,2018.925 primary care patients responded to the survey,for an overall response rate of 92.5%.The reliability and validity of the revised Chinese version of the Primary Care Assessment Tool scale were good(the total Cronbach alpha coefficient of the scale was 0.924>0.8,KMO=0.849,Bartlett's test of sphericity?~2=15285.72,that is,P<0.05).Statistical description,independent sample T test,variance analysis and chi-square test were used to compare the general information of the questionnaire and the scale information,and multiple linear regression analysis was used to analyze the factors related to the total Primary Care Assessment Tool score.Results:1.The community health service center of patients there was no significant difference between gender composition,but the educational level,the types of registered permanent residence,domicile of origin,marital status,community health service institutions,family per capita income,The Times of self-evaluation of health,community choice,self-reported chronic diseases and health care,pay mode to see a doctor,health records,age distribution has obvious statistical difference(P<0.05).2.The overall results of this survey showed that the total score of patient experience was67.55±14.17;Rank each dimension:Comprehensiveness(2.95±0.74),Continuity of care(2.79±0.64),first contact(2.69±0.70),Coordination of services(2.67±0.69),family centeredness(2.56±0.71),Community orientation(2.19±0.85).3.The patients experience rating between degree of culture,the types of registered permanent residence,domicile of origin,marital status,community health service institutions,family per capita income,Self-perceived health status,community choice,Presence of self-perceived long-term physical/mental problem,self health care,Presence of medical insurance,health records,age group,has significant statistical difference(P<0.05).4.There was a positive correlation between patient satisfaction and patient experience in community health service centers(r=0.386,P<0.001).5.The patient experience scores of four community health service centres were ranked from high to low as follows:the community health service center run by enterprises(70.83±13.41),The traditional community health service center(69.55±14.66),Community health service center within the hospital run by tertiary hospitals(66.24±15.82),and Community health service center outside the hospital run by tertiary hospitals(63.56±11.35).There were significant differences in Community health service center patient experience among different models(P<0.01).6.Patient experience in the four community health service centres showed differences in the six dimensions of first-contact,Continuity of care,coordination service,comprehensive service,family centeredness,Community orientation.(P<0.05).Conclusion:1.The revised Chinese version of the Primary Care Assessment Tool measurement tool has good reliability and structural validity.2.The total patient experience score of the 4 community health service centers was67.55±14.17.If a score above 75 is considered excellent,the overall patient experience score of this survey below the standard of excellent level.3.There is a positive correlation between patient experience and satisfaction;In the quality information feedback,the patient experience score can reflect the quality level of community health services in more detail,which can provide managers with more decision-making basis for feedback.4.On the whole,compared with other types of community health service centers,the community health service centers run by enterprises have better patient experience score.In particular,it performs well in the service dimension of first-contact service,continuous service and family centeredness.The traditional community health service center has the highest score in coordination service.Community health service centers run by tertiary hospitals performed better in community orientation...