Model Building And Service Improve Strategy Research Of Patient-Centered Care

Patient-centered care(PCC)is recognized a core value in healthcare system reform and the development throughout the world.Large numbers of studies have shown that it can effectively bridge the doctor-patient relationship gap caused by too detailed divided medical discipline,reshape health care humanistic attribute,and raise quality of healthcare and efficiency of the output.The PCC stresses that health care should be based on patients' needs,preferences,and values,and that medical decision-making process should involve patients and their families,to build a partnership between doctors and patients to overcome diseases together.Recent years,the medical and healthcare system reform in China gradually move into the deep water area,reform is ongoing,with the rapidly development of economy,something new had appeared,such as the excessively rapid growth of total health expenses,the demand for high-quality health care,patients' demand for medical democratization after the wide application of big data,and so on.How to meet these challenges,good experience of developed countries tells us that the implementation of PCC is an effective pathway.Therefore,this research is of great benefit to guide relevant practice to research Chinese PCC theory and specific based on Guangdong province's(GD)actual conditionsObjective:Purposes of this study was,firstly,to construct a PCC model suitable for China's special condition on the basis of the existing research results on PCC worldwide.Secondly,based on the model,investigate the patients' perception of PCC in GD,so as to provide reference for relevant research and policy-making.In addition,based on empirical research,proposes stratege recommendations for medical institutions to practice PCCMethods:Methods used in this study mainly including:(1)literature research method:the classic models of PCC worldwide and relevant research literature were summarized in detail to build the theoretical basis of the research.(2)Semi-structured focus group interview:Based on the four regions of GD,semi-structured group interviews were conducted among inpatients,doctors,and nurses to construct a PCC model framework.(3)Questionnaire survey:A large sample of inpatients survey was conducted in GD to evaluate its patients'PCC level.(4)Data processing and analysis methods:Data entry was conducted using Epidata software,data analysis and modeling was conducted based on SPSS,Amos and Nvivo software,and descriptive statistics,analysis of variance,multi-factor regression model,confirmatory factor analysis,text encoding and modeling were comprehensively adoptedResults:The overall score of PCC in Guangdong Province was 8.60±1.38(mean±SD).The lowest score of PCC 7 dimensions was 7.96±2.08 for medical insurance,and the highest score was 8.97±1.35 for patients' experience.The inpatients' scores on the other five dimensions were:hospital environment 8.54±1.50,medical quality 8.63±1.45,shared-decision making 8.78±1.54,doctor-patient relationship 8.89±1.49 and disease management 8.54± 1.65 respectively.The PCC score of patients from rural areas was significantly lower than that of patients from cities and towns;scores of patients in Pearl River Delta and eastern GD were significantly higher than those in western and northern GD.Conclusion:(1)The PCC model constructed in this study has 7 dimensions,namely hospital environment,medical quality,shared-decision making,patients'experience,doctor-patient communication,medical insurance,disease management.The model includes 25 items.(2)To improve the patient-centered care in medical institutions,we should first focus on the improvement of the medical results,and then promote the transformation and upgrading of medical services to "quality-oriented".(3)Taking targeted measures from the seven dimensions of the model can effectively promote the improvement of the patient-centered care ability of medical institutions.