Experience of Lifetime Health Maintenance Clinic in a Tertiary Hospital: Patients Satisfaction and Associated Factors

Seung Woo Lee; Na Ra Cho; Seung Hyun Yoo; Sung Sunwoo

doi:10.15384/kjhp.2017.17.3.176

Korean J Health Promot > Volume 17(3); 2017 > Article

Experience of Lifetime Health Maintenance Clinic in a Tertiary Hospital: Patients Satisfaction and Associated Factors

Original Article

Korean Journal of Health Promotion 2017;17(3):176-183.

Published online: January 19, 2017

DOI: https://doi.org/10.15384/kjhp.2017.17.3.176

Experience of Lifetime Health Maintenance Clinic in a Tertiary Hospital: Patients Satisfaction and Associated Factors

Seung Woo Lee, Na Ra Cho, Seung Hyun Yoo, Sung Sunwoo

Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Corresponding author : Sung Sunwoo, MD, PhD Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olymphic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
Tel: +82-2-3010-3813, Fax: +82-2-3010-3815 E-mail: sws@amc.seoul.kr

Received July 18, 2017 Accepted August 23, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

요약

Background:

Lifetime health maintenance program (LHMP) is designed for individualized disease prevention and health promotion through regular health checkups and improving risk factors. This study aimed to investigate patients’ satisfaction of lifetime health clinic (LHC) in a tertiary hospital and to evaluate associated factors in order to support primary health care strengthening policy.

Methods:

We conducted surveys for patients, who visited LHC in a department of family medicine at a tertiary hospital from March 1st 2016 to December 31st 2016. We analyzed proportions and characteristics associated with patients, who were willing to recommend LHC. The relationship between willingness to recommend LHC and associated factors were evaluated by multivariate logistic regression analyses.

Results:

Among the patients who answered the questionnaires, 83.7% responded that they would recommend LHC to others. Results from multivariate analyses suggested that patients living in provinces (odds ratio [OR] 4.21, 95% confidence interval [CI], 1.36-13.02), patients who were recommend by others to visit LHC (OR 3.99, 95% CI, 1.29-12.35), and those who had a large number of medical service preference items (OR 5.91, 95% CI, 1.48-23.58) were significantly associated with willingness to recommend LHC.

Conclusions:

LHC pursues the goal of primary care. Findings highlight the fact that high quality health service should be provided in small and municipal hospitals to improve patients’ satisfaction. Furthermore, it is essential to establish family physician networks and health service infrastructure that can reflect various opinions.

Keywords: Lifetime Health Maintenance Program, Patient satisfaction, Primary care

Table 1.

Basic characteristics of the patients (n=184)

Characteristic	Value
Age, y
≤59	52 (28.3)
60 to 69	73 (39.7)
≥70	59 (32.1)
Gender
Male	92 (50.0)
Female	92 (50.0)
Reason for registration
Recommendation by physicians in family department	95 (51.6)
Recommendation by physicians in another department	9 (4.9)
Brochures	10 (5.4)
Recommendation by acquaintance	63 (34.2)
Recommendation by family	7 (3.8)
Registration count
One time	54 (29.3)
Two times	20 (10.9)
Three times	14 (7.6)
Four times	2 (1.1)
More than five times	94 (51.1)
Comorbidities (multiple choice)
Hypertension	110 (59.8)
Diabetes mellitus	52 (28.3)
Dyslipidemia	104 (56.5)
Osteoporosis	26 (14.1)
Gastrointestinal disease	31 (16.8)
Depression	16 (8.7)
Thyroid disease	17 (9.2)
Prostate disease	25 (8.6)
Menopause	7 (3.8)
Questionnaire items for evaluating satisfaction (multiple choice)
Detailed explanation by family physician	182 (98.9)
Personalized checkups	156 (84.8)
All day helpline	97 (52.7)
Notification of the scheduled date for checkup	96 (52.2)
Offering healthcare newsletters	75 (40.8)
Kindness of medical team	151 (82.1)
Same-day appointment	105 (57.1)
Fast reservation	102 (55.4)
Purpose of visit (multiple choice)	57 (31.0)
Illness visits	57 (31.0)
Wellness visits	129 (70.1)
Consultation visits	35 (19.0)

Values are presented as number (%) or mean (SD). Data are analyzed by Frequency and Descriptive analysis.

Table 2.

Clinical characteristics of the patients according to the willingness to recommend LHC

Characteristic	Outpatients
Characteristic	Total (n=184)	Recommend (n=154)	Not recommend (n=30)	P^a
Age, y		64.53±12.19	64.33±11.65	0.957
≤59	52 (28.3)	43 (82.7)	9 (17.3)
60-69	73 (39.7)	61 (83.6)	12 (16.4)
70≥	59 (32.1)	50 (84.7)	9 (15.3)
Gender				0.000
Male	92 (50)	77 (83.7)	15 (16.3)
Female	92 (50)	77 (83.7)	15 (16.3)
Reason for registration				0.017
Recommendation by physicians	104 (56.5)	80 (76.9)	24 (23.1)
Brochures	10 (5.4)	9 (90.0)	1 (10.0)
Recommendation of acquaintance	70 (38.0)	65 (92.9)	5 (7.1)
Registration count				0.219
One	54 (29.3)	43 (79.6)	11 (20.4)
Two-four	36 (19.6)	28 (77.8)	8 (22.2)
More than five	94 (51.1)	83 (88.3)	11 (11.7)
Area				0.008
Metropolitan (Seoul)	114 (62.0)	89 (78.1)	25 (21.9)
Provinces	70 (38.0)	65 (92.9)	5 (7.1)
Numbers of disease				0.701
One	54 (29.3)	47 (87.0)	7 (13.0)
Two	70 (38.0)	57 (81.4)	13 (18.6)
More than three	60 (32.6)	50 (83.3)	10 (16.7)
Questionnaire items for evaluating satisfaction (multiple choice)				0.042
Less than three	52 (28.3)	41 (78.8)	11 (21.2)
Four-six	71 (38.6)	56 (78.9)	15 (21.1)
Seven-eight	61 (33.2)	57 (93.4)	4 (6.6)
Purpose of visit (multiple choice)
Illness visits				0.461
Yes	57 (31.0)	46 (80.7)	11 (19.3)
No	127 (69.0)	108 (85.0)	19 (15.0)
Wellness visits				0.376
Yes	129 (70.1)	110 (85.3)	19 (14.7)
No	55 (29.9)	44 (80.0)	11 (20.0)
Consultation visits				0.386
Yes	35 (19.0)	31 (88.6)	4 (11.4)
No	149 (81.0)	123 (82.6)	26 (17.4)

Abbreviation: LHC, lifetime health clinic. Values are presented as number (%) or mean±standard deviation.

^aP-values are analyzed by chi-square test

Table 3.

Multivariate analyses of the characteristics associated with willingness to recommend LHC

Variable	Crude OR (95% Cl)	P	Multivariable OR^a (95% Cl)	P^b
Age, y
≤59	1	N/A	1	N/A
60-69	1.06 (0.41-2.75)	0.898	1.79 (0.58-5.58)	0.314
≥70	1.16 (0.42-3.19)	0.770	2.22 (0.65-7.55)	0.202
Gender
Male	1	N/A	1	N/A
Female	1.00 (0.46-2.19)	1.00	1.15 (0.46-2.86)	0.763
Area
Metropolitan (Seoul)	1	N/A	1	N/A
Provinces	3.65 (1.33-10.05)	0.012	4.21(1.36-13.02)	0.013
Reason for registration
Recommendation of medical staff	1	N/A	1	N/A
Brochures	2.70 (0.33-22.40)	0.358	4.14 (0.39-44.33)	0.240
Recommendation of acquaintance	3.90 (1.41-10.79)	0.009	3.99 (1.29-12.35)	0.016
Registration Count
One	1	N/A	1	N/A
Two-four	0.90 (0.32-2.50)	0.833	0.78 (0.23-2.70)	0.696
More than five	1.93 (0.77-4.81)	0.158	2.22 (0.75-6.62)	0.152
Numbers of disease
One	1	N/A	1	N/A
Two	0.65 (0.24-1.77)	0.402	0.52 (0.16-1.66)	0.279
More than three	0.75 (0.26-2.12)	0.580	0.78 (0.24-2.52)	0.782
Questionnaire items for evaluating satisfaction
Less than three	1	N/A	1	N/A
Four-six	1.00 (0.42-2.41)	0.997	1.26 (0.45-3.50)	0.657
Seven-eight	3.82 (1.14-12.86)	0.030	5.91 (1.48-23.58)	0.012
Purpose of visits (multiple choice)
Illness visits
No	1	N/A	1	N/A
Yes	0.74 (0.32-1.67)	0.463	1.19 (0.32-4.38)	0.795
Wellness visits
No	1	N/A	1	N/A
Yes	1.45 (0.64-3.29)	0.377	1.17 (0.44-6.53)	0.448
Consultations visits
No	1	N/A	1	N/A
Yes 1.64 (0.53-5.04) 0.389 1.62 (0.34-7.76) 0.547

Abbreviations: LHC, lifetime health clinic; OR, odds ratio; CI, confidence interval; NA, not applicable.

^aMultivariable OR are adjusted for age, gender, area, cause of registration, counts of registration, numbers of disease, satisfaction question, purpose of visit.

^bP-values are analyzed by logistic regression and statistically significant P<0.05 are shown.

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