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Can Primary Medical Institutions Lead to Worse Health Status for Patients with Noncommunicable Diseases Compared with High-Level Hospitals? A Follow-Up Observation Study in China

Author

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  • Yadong Niu

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Ting Ye

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Yan Zhang

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Liang Zhang

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

Abstract

The weak primary healthcare system in China brings challenges to the national strategy of primary medical institutions providing general health needs for patients with non-communicable diseases (NCDs). It is necessary to explore the potential discrepancies in health status for patients with NCDs if they go to primary medical institutions rather than high-level hospitals. Data was obtained from Surveillance of Health-seeking Behavior in Hubei Province. Respondents were investigated six times to collect information on health service utilization and health-related quality of life (HRQoL). Ninety-two hypertension patients who went to medical institutions of the same level were included. HRQoL was measured by the Chinese version of EQ-5D-3L. A multilevel growth curve model was applied to analyze whether provider level could influence HRQoL. The utility score and visual analogue scale (VAS) of patients varied insignificantly over six months ( p > 0.05). A growth curve model showed that comorbidity was the only factor significantly influencing utility score ( p = 0.019). Time and comorbidity were the only influencing factors of VAS ( p < 0.05). Our findings indicated that the level of healthcare provider had no significant impact on the health status of patients with NCDs. As such, this study concludes that the primary healthcare system in China is qualified to be the health gatekeeper for NCDs patients.

Suggested Citation

  • Yadong Niu & Ting Ye & Yan Zhang & Liang Zhang, 2019. "Can Primary Medical Institutions Lead to Worse Health Status for Patients with Noncommunicable Diseases Compared with High-Level Hospitals? A Follow-Up Observation Study in China," IJERPH, MDPI, vol. 16(8), pages 1-9, April.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:8:p:1336-:d:222620
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    References listed on IDEAS

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    1. Chi Zhang, 2017. "Population in China," Europe-Asia Studies, Taylor & Francis Journals, vol. 69(8), pages 1333-1334, September.
    2. Tapio Nummi, 1997. "Estimation in a random effects growth curve model," Journal of Applied Statistics, Taylor & Francis Journals, vol. 24(2), pages 157-168.
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    Cited by:

    1. Xiang Jing & Lingzhong Xu & Wenzhe Qin & Jiao Zhang & Lu Lu & Yali Wang & Yu Xia & An’an Jiao & Yaozu Li, 2020. "The Willingness for Downward Referral and Its Influencing Factors: A Cross-Sectional Study among Older Adults in Shandong, China," IJERPH, MDPI, vol. 17(1), pages 1-13, January.
    2. Erping Jia & Yuanyuan Gu & Yingying Peng & Xianglin Li & Xiao Shen & Mingzhu Jiang & Juyang Xiong, 2020. "Preferences of Patients with Non-Communicable Diseases for Primary Healthcare Facilities: A Discrete Choice Experiment in Wuhan, China," IJERPH, MDPI, vol. 17(11), pages 1-15, June.
    3. Wei Hsu & Chih-Hao Yang & Wen-Ping Fan, 2021. "A Study of Patients’ Willingness to Pay for a Basic Outpatient Copayment and Medical Service Quality in Taiwan," IJERPH, MDPI, vol. 18(12), pages 1-12, June.

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