The impact of accessibility and service quality on the frequency of patient visits to the primary diabetes care provider: results from a cross-sectional survey performed in six European countries.
Adult
Ambulatory Care
/ statistics & numerical data
Communication
Cross-Sectional Studies
Diabetes Mellitus, Type 2
/ therapy
Europe
Female
Health Care Surveys
Health Services Accessibility
/ statistics & numerical data
Humans
Male
Middle Aged
Physician-Patient Relations
Primary Health Care
/ statistics & numerical data
Quality of Health Care
/ statistics & numerical data
Travel
/ statistics & numerical data
Accessibility to care
Health care provider
In-practice waiting time
Provider-patient communication
Travel distance
Travel time
Type 2 diabetes
Visit
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
26 Aug 2020
26 Aug 2020
Historique:
received:
08
03
2019
accepted:
10
06
2020
entrez:
28
8
2020
pubmed:
28
8
2020
medline:
29
12
2020
Statut:
epublish
Résumé
Visits to the primary diabetes care provider play a central role in diabetes care. Therefore, patients should attend their primary diabetes care providers whenever a visit is necessary. Parameters that might affect whether this condition is fulfilled include accessibility (in terms of travel distance and travel time to the practice), as well as aspects of service quality (for example in-practice waiting time and quality of the provider's communication with the patient). The relationships of these variables with the frequency of visits to the primary diabetes care provider are investigated. The investigation is performed with questionnaire data of 1086 type 2 diabetes patients from study regions in England (213), Finland (135), Germany (218), Greece (153), the Netherlands (296) and Spain (71). Data were collected between October 2011 and March 2012. Data were analysed using log-linear Poisson regression models with self-reported numbers of visits in a year to the primary diabetes care provider as the criterion variable. Predictor variables of the core model were: country; gender; age; education; stage of diabetes; heart problems; previous stroke; problems with lower extremities; problems with sight; kidney problems; travel distance and travel time; in-practice waiting time; and quality of communication. To test region-specific characteristics, the interaction between the latter four predictor variables and study region was also investigated. When study regions are merged, travel distance and in-practice waiting time have a negative effect, travel time no effect and quality of communication a positive effect on visit frequency (with the latter effect being by far largest). When region specific effects are considered, there are strong interaction effects shown for travel distance, in-practice waiting time and quality of communication. For travel distance, as well as for in-practice waiting time, there are region-specific effects in opposite directions. For quality of communication, there are only differences in the strength with which visit frequency increases with this variable. The impact of quality of communication on visit frequency is the largest and is stable across all study regions. Hence, increasing quality of communication seems to be the best approach for increasing visit frequency.
Sections du résumé
BACKGROUND
BACKGROUND
Visits to the primary diabetes care provider play a central role in diabetes care. Therefore, patients should attend their primary diabetes care providers whenever a visit is necessary. Parameters that might affect whether this condition is fulfilled include accessibility (in terms of travel distance and travel time to the practice), as well as aspects of service quality (for example in-practice waiting time and quality of the provider's communication with the patient). The relationships of these variables with the frequency of visits to the primary diabetes care provider are investigated.
METHODS
METHODS
The investigation is performed with questionnaire data of 1086 type 2 diabetes patients from study regions in England (213), Finland (135), Germany (218), Greece (153), the Netherlands (296) and Spain (71). Data were collected between October 2011 and March 2012. Data were analysed using log-linear Poisson regression models with self-reported numbers of visits in a year to the primary diabetes care provider as the criterion variable. Predictor variables of the core model were: country; gender; age; education; stage of diabetes; heart problems; previous stroke; problems with lower extremities; problems with sight; kidney problems; travel distance and travel time; in-practice waiting time; and quality of communication. To test region-specific characteristics, the interaction between the latter four predictor variables and study region was also investigated.
RESULTS
RESULTS
When study regions are merged, travel distance and in-practice waiting time have a negative effect, travel time no effect and quality of communication a positive effect on visit frequency (with the latter effect being by far largest). When region specific effects are considered, there are strong interaction effects shown for travel distance, in-practice waiting time and quality of communication. For travel distance, as well as for in-practice waiting time, there are region-specific effects in opposite directions. For quality of communication, there are only differences in the strength with which visit frequency increases with this variable.
CONCLUSIONS
CONCLUSIONS
The impact of quality of communication on visit frequency is the largest and is stable across all study regions. Hence, increasing quality of communication seems to be the best approach for increasing visit frequency.
Identifiants
pubmed: 32847573
doi: 10.1186/s12913-020-05421-0
pii: 10.1186/s12913-020-05421-0
pmc: PMC7449065
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
800Subventions
Organisme : European Community's Seventh Framework
ID : 241741
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