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

Yadong Niu, Ting Ye, Yan Zhang and Liang Zhang
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Yadong Niu: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Ting Ye: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Yan Zhang: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
Liang Zhang: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

IJERPH, 2019, vol. 16, issue 8, 1-9

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.

Keywords: non-communicable diseases; health-related quality of life; service quality; primary medical institutions; China; follow-up study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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