The effect of the quality of primary care physicians evaluated from a patient-centered perspective on the patient's behavior

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K19348
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: Chiba University
• Principal Investigator: Ikegami Akiko 千葉大学, 医学部附属病院, 医員 (60731073)
• Project Period (FY): 2019-02-01 – 2023-03-31
• Keywords: 受療行動 / 患者中心性

Outline of Final Research Achievements

In this study, we aimed to evaluate the quality of primary care physicians (PCPs) in terms of their gatekeeping functionality. To accomplish this, we surveyed patients who visited the Department of General Medicine at the University Hospital about their behavior toward their PCPs, and their patient experience to the five primary care principles: first contact, longitudinality, coordination, comprehensiveness, and community orientation. The results revealed that a significant number of patients did not have contact with their PCPs or were not referred by them, even though they had a PCP. However, patients who were referred by their PCPs had higher scores for first contact (ability to see a doctor at any time) and coordination (timely and appropriate referral). Based on these findings, it is suggested that the gatekeeping functionality of PCPs can be improved by implementing a system to make progress these factors.

Free Research Field

総合診療

Academic Significance and Societal Importance of the Research Achievements

本研究では、多様な受療行動を経て大学病院を受診する患者に対して初めて、かかりつけ医の質と受療行動との関連について調査を実施した。その結果、かかりつけ医がいても受診しない、紹介状をもらって来ない患者が多くいる実態が明らかになり、プライマリ・ケアを担う医師が必ずしも全領域診療に対応出来ているわけではない可能性が示唆された。現在かかりつけ医制度が検討されているが、プライマリ・ケアの特性のうち、近接性や協調性の向上をはかる仕組みを構築できれば、かかりつけ医をバイパスしない紹介を促すことができ、結果としてかかりつけ医によるゲートキーパー機能の向上が期待される。