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
- Received July 18, 2017 Accepted August 23, 2017
- ABSTRACT
-
- 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.
Table 1.
Basic characteristics of the patients (n=184)
Table 2.
Clinical characteristics of the patients according to the willingness to recommend LHC
| Characteristic | Outpatients | |||
|---|---|---|---|---|
| Total (n=184) | Recommend (n=154) | Not recommend (n=30) | Pa | |
| 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) | |
Table 3.
Multivariate analyses of the characteristics associated with willingness to recommend LHC
| Variable | Crude OR (95% Cl) | P | Multivariable ORa (95% Cl) | Pb |
|---|---|---|---|---|
| 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 | ||||
- REFERENCES
- REFERENCES
- 1.. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q 2005;83(3):457-502.
[Article] [PubMed] [PMC]2.. Starfield B, Shi L. Policy relevant determinants of health: an international perspective. Health Policy 2002;60(3):201-18.
[Article] [PubMed]3.. Atun R. What are the advantages and disadvantages of restructuring a health care system to be more focused on primary care services? 2004 World Health Organization Regional Office for Europe. 2004;[cited 2004 Jan 20]. Available from:. http://www.euro.who.int/document/e82997.pdf.4.. Macinko J, Starfield B, Shi L. The contribution of primary care systems to health outcomes within Organization for Economic Cooperation and Development (OECD) countries, 1970-1998. Health Serv Res 2003;38(3):831-65.
[Article] [PubMed] [PMC]5.. Kim EJ, Yoon SJ, Jo MW, Kim HJ. Measuring the burden of chronic diseases in Korea in 2007. Public Health 2013;127(9):806-13.
[Article] [PubMed]6.. Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases: how many lives can we save? Lancet 2005;366(9496):1578-82.
[Article] [PubMed]7.. Cho HJ, Shim JY, Lee HR, Lee SH. Factors associated with possession of regular doctor in Korea. J Korean Acad Fam Med 2001;22(11):1612-21.8.. Bong SW, Kim TH, Kim SS, Kim YS. An interview survey on opinions concerning the necessity for family doctor registration program and its major services. J Korean Acad Fam Med 2006;27(3):370-5.9.. Cho HJ, Shim JY, Lee HR, Lee SH. What do Korean people think of family doctor registration program? J Korean Acad Fam Med 2002;23(2):171-8.10.. Huh BY, Kim CH, Park TJ, Lee KY, Cho BL, Kim HJ. Development and evaluation of home doctor registration program. J Korean Acad Fam Med 1998;19(10):801-10.11.. Park M, Kim SY, Kim YS, Sunwoo S, Cho JJ. Periodic Health Examination and Prevention Guidelines for Koreans. Korean J Fam Med 2009;30(10):761-8.
[Article]12.. Kim SY, Kim YS, Park MS, Sunwoo S, Cho JJ. Methodology of Korean lifetime health maintenance program. Korean J Fam Med 2009;30(10):769-76.
[Article]13.. Hwang J, Park HA. Patient satisfaction as an outcome indicator. J Korean Acad Adult Nurs 2001;13(1):29-39.14.. Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann 1983;6(3-4):185-210.
[Article] [PubMed]15.. Linder-Pelz SU. Toward a theory of patient satisfaction. Soc Sci Med 1982;16(5):577-82.
[Article] [PubMed]16.. Kim KS, Ree SB. Empirical study on customer satisfaction and others factor influencing "would recommend" in NPS(Net Promoter Score) - Focus on Kitchen furniture -. J Korean Soc Quality Manage 2009;37(2):58-67.17.. Ghorbani A, Raeissi P, Saffari E, Reissi N. Patient satisfaction with the Family Physician Program in Sabzevar, Iran. Glob J Health Sci 2016;8(2):219-29.
[Article] [PubMed] [PMC]18.. Pini A, Sarafis P, Malliarou M, Tsounis A, Igoumenidis M, Bamidis P, et al. Assessment of patient satisfaction of the quality of health care provided by outpatient services of an oncology hospital. Glob J Health Sci 2014;6(5):196-203.
[Article]19.. Jeong H, Lee H, Lee JH, Lee T. Payment reform for the improvement of primary care in Korea. J Korean Med Assoc 2013;56(10):881-90.
[Article]20.. Dourgnon P, Naiditch M. The preferred doctor scheme: a political reading of a French experiment of gate-keeping. Health Policy 2010;94(2):129-34.
[Article] [PubMed]21.. Kralj B, Kantarevic J. Primary care in Ontario: reforms, investments and achievements. Ont Med Rev 2012;79(2):18-24.22.. Ganasegeran K, Perianayagam W, Manaf RA, Jadoo SA, Al-Dubai SA. Patient satisfaction in Malaysia's busiest outpatient medical care. ScientificWorldJournal 2015;2015:714754.
[Article] [PubMed] [PMC]23.. Li J, Wang P, Kong X, Liang H, Zhang X, Shi L. Patient satisfaction between primary care providers and hospitals: a cross-sectional survey in Jilin province, China. Int J Qual Health Care 2016;28(3):346-54.
[Article] [PubMed]24.. Sun J, Hu G, Ma J, Chen Y, Wu L, Liu Q, et al. Consumer satisfaction with tertiary healthcare in China: findings from the 2015 China National Patient Survey. Int J Qual Health Care 2017;29(2):213-21.
[Article] [PubMed]25.. Park SM, Cho JJ, Park YG, Kim YS. Public perception of the need for regular family doctors, their major role, and appropriate training duration. Korean J Fam Pract 2013;3(2):124-31.26.. Seo HG, Kang JH, Kim CH, Kim SW. A telephone survey on the opinions about family doctor. Korean J Prev Med 1998;31(2):310-22.