Positive Association Between Patient Experience of Primary Care with Chronic Disease and Self-rated Health in a Japanese Rural Area: A Cross-sectional Questionnaire Survey Using the Japanese Primary Care Assessment Tool Short Form

Overview

Journal J Gen Fam Med

Specialty Public Health

Date 2024 Nov 18

PMID 39554296

Authors

Sakiya Nishida

Yoshio Hisata

Aki Yasaka

Takashi Sugioka

Risa Hirata

Naoko E Katsuki

Masaki Tago

Yuki Ueda

Masaki Amenomori

Katsumi Higashino

Yoshio Naya

Affiliations

Soon will be listed here.

Abstract

Background: Low birthrates and an aging society during population decline have brought about labor shortages and increased medical care needs. Medical resources should be distributed appropriately, particularly in rural areas. High-quality primary care can make the medical system more effective and contribute to rural residents' health. However, there are no reports on the impact of primary care on health in the rural areas of Japan. This study examined the effect of primary care quality on self-rated health in a rural Japanese area.

Methods: We conducted a cross-sectional study using a questionnaire survey of residents of a rural area in northern Shiga Prefecture in 2021. Self-rated health (SRH) was used as the health outcome (1-5 points), and the Japanese Primary Care Assessment Tool Short Form (JPCAT-SF) was used to measure the patients' experience of primary care (0-100 points). We conducted a multivariate analysis using logistic regression analysis and examined the association between good SRH (4 points or more) and high JPCAT-SF scores (above average score), adjusted for sociodemographic confounding factors.

Results: A total of 1108 men and 1412 women responded to the survey. The mean patient age was 69.8 years. The mean JPCAT-SF score was 51.8 points. Among the 1172 patients with chronic diseases, good SRH was associated with high JPCAT-SF scores (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.009-1.73).

Conclusions: Good SRH among rural residents with chronic disease was associated with high primary care quality.

References

Bazemore A, Petterson S, Peterson L, Phillips Jr R . More Comprehensive Care Among Family Physicians is Associated with Lower Costs and Fewer Hospitalizations. Ann Fam Med. 2015; 13(3):206-13. PMC: 4427414. DOI: 10.1370/afm.1787. View

Jin H, Wang Z, Shi L, Chen C, Huo Y, Huang W . Multimorbid Patient Experiences With Primary Care at Community Health Centers in Shanghai, China. Front Public Health. 2021; 9:606188. PMC: 8218628. DOI: 10.3389/fpubh.2021.606188. View

Sung N, Markuns J, Park K, Kim K, Lee H, Lee J . Higher quality primary care is associated with good self-rated health status. Fam Pract. 2013; 30(5):568-75. DOI: 10.1093/fampra/cmt021. View

Wang W, Shi L, Yin A, Mao Z, Maitland E, Nicholas S . Contribution of primary care to health: an individual level analysis from Tibet, China. Int J Equity Health. 2015; 14:107. PMC: 4663737. DOI: 10.1186/s12939-015-0255-y. View

Haggerty J, Burge F, Beaulieu M, Pineault R, Beaulieu C, Levesque J . Validation of instruments to evaluate primary healthcare from the patient perspective: overview of the method. Healthc Policy. 2012; 7(Spec Issue):31-46. PMC: 3399433. View

Aoki T, Yamamoto Y, Fukuhara S . Comparison of Primary Care Experience in Hospital-Based Practices and Community-Based Office Practices in Japan. Ann Fam Med. 2020; 18(1):24-29. PMC: 7227459. DOI: 10.1370/afm.2463. View

Green M, Schubart J, Whitehead M, Farace E, Lehman E, Levi B . Advance Care Planning Does Not Adversely Affect Hope or Anxiety Among Patients With Advanced Cancer. J Pain Symptom Manage. 2014; 49(6):1088-96. DOI: 10.1016/j.jpainsymman.2014.11.293. View

Gu J, Ming X . The Influence of Living Conditions on Self-Rated Health: Evidence from China. Int J Environ Res Public Health. 2021; 18(17). PMC: 8431523. DOI: 10.3390/ijerph18179200. View

Kringos D, Boerma W, Hutchinson A, Zee J, Groenewegen P . The breadth of primary care: a systematic literature review of its core dimensions. BMC Health Serv Res. 2010; 10:65. PMC: 2848652. DOI: 10.1186/1472-6963-10-65. View

10.

Aoki T, Inoue M, Nakayama T . Development and validation of the Japanese version of Primary Care Assessment Tool. Fam Pract. 2015; 33(1):112-7. DOI: 10.1093/fampra/cmv087. View

11.

Cott C, Gignac M, Badley E . Determinants of self rated health for Canadians with chronic disease and disability. J Epidemiol Community Health. 2000; 53(11):731-6. PMC: 1756802. DOI: 10.1136/jech.53.11.731. View

12.

Mitsutake S, Ishizaki T, Teramoto C, Shimizu S, Ito H . Patterns of Co-Occurrence of Chronic Disease Among Older Adults in Tokyo, Japan. Prev Chronic Dis. 2019; 16:E11. PMC: 6362710. DOI: 10.5888/pcd16.180170. View

13.

Ganna A, Ingelsson E . 5 year mortality predictors in 498,103 UK Biobank participants: a prospective population-based study. Lancet. 2015; 386(9993):533-40. DOI: 10.1016/S0140-6736(15)60175-1. View

14.

Kotani K . The framework for modern community medicine in Japan. Biosci Trends. 2023; 17(4):322-324. DOI: 10.5582/bst.2023.01199. View

15.

Aoki T, Fukuhara S, Yamamoto Y . Development and validation of a concise scale for assessing patient experience of primary care for adults in Japan. Fam Pract. 2019; 37(1):137-142. DOI: 10.1093/fampra/cmz038. View

16.

Matsuda S . Health Policy in Japan - Current Situation and Future Challenges. JMA J. 2021; 2(1):1-10. PMC: 7930804. DOI: 10.31662/jmaj.2018-0016. View

17.

Kaneko M, Higuchi T, Ohta R . Primary care physicians working in rural areas provide a broader scope of practice: a cross-sectional study. BMC Prim Care. 2024; 25(1):9. PMC: 10759475. DOI: 10.1186/s12875-023-02250-y. View

18.

Dullie L, Meland E, Mildestvedt T, Hetlevik O, Gjesdal S . Quality of primary care from patients' perspective: a cross sectional study of outpatients' experience in public health facilities in rural Malawi. BMC Health Serv Res. 2018; 18(1):872. PMC: 6245776. DOI: 10.1186/s12913-018-3701-x. View