基层医疗卫生机构慢性病患者感知参与和常规卫生服务来源的关系研究OA

Objective To explore the latent classes of perceived involvement among patients with chronic diseases in primary health care institution,analyze the relationship between these classes and usual source of care,and provide a theoretical basis for guiding rational healthcare-seeking behaviors in this population.Methods 920 patients with chronic diseases in Shandong Prov-ince were chosen by using a multistage stratified sampling method,and conducted cross-sectional survey.Latent class analysis was applied to categorize patient perceived involvement,and binary logistic regression analysis was used to examine the association between latent classes of perceived involvement and usual source of care.Results Three distinct latent classes were identified as low patient perceived involvement(15.00％),moderate patient perceived involvement(39.67％),and high patient perceived involvement(45.33％).The probability of being classified into the low perceived involvement class was significantly higher in pa-tients aged ≥60 years(16.79％)than those in aged＜60 years(13.52％)(P＜0.05).Divorced or widowed patients had a significantly higher probability of belonging to the low perceived involvement class(26.57％)compared with married patients(11.95％)(P＜0.05).Unemployed patients showed a significantly higher rate of low perceived involvement(18.20％)than employed patients(10.87％)(P＜0.05).Furthermore,patients with low perceived involvement were significantly less likely to regard primary health care institution as their usual source of care compared with those with moderate perceived involvement(OR=3.303,P＜0.001)and high perceived involvement(OR=4.610,P＜0.001).Conclusion Active involvement of patients with chronic diseases during visits to primary health care institutions can increase the likelihood of these institutions being used as their usual source of care.Primary health care institution should strengthen patient involvement during consultations to enhance the uti-lization of primary health services.