Healthcare Policy Vol. 7 No. 3 2012

摘要

Purpose: To explore the association between primary healthcare (PHC) organizational model and health-related quality of life (HRQoL) in persons with chronic disease. Methods: We recruited 776 patients with a primary diagnosis of one of four chronic diseases from 33 PHC clinics. Patients were interviewed at baseline, 6, 12 and 18 months. We categorized PHC model by administrative type and by a taxonomy according to organizational attributes. HRQoL was measured by disease-specific questionnaires. Results: Mean age was 67 years and 55.3% were female. PHC models differed with respect to case mix: community models served older patients with higher co-morbidity and lower health status. Multilevel logistic regression revealed that none of the PHC organizational models was associated with HRQoL. Having fewer co-morbidities, higher self-rated health and not using home care services were associated with higher HRQoL. Conclusion: Despite their having patients with more complex health problems, HRQoL in patients of community practices was equivalent to that of patients in other types of PHC organizations.