Hospital based primary care clinics. Complementary to general practice. 1997

S T Liaw, and D Young
Department of Public Health and Community Medicine, University of Melbourne, Victoria.

OBJECTIVE To describe the patients attending a hospital based primary care clinic (HBPCC) focusing on the main medical and non-medical reasons for their seeking health care at the clinic, and their expectations of, and satisfaction with the care. METHODS The study was set in a HBPCC in the northern region of metropolitan Melbourne, Australia. Bilingual interviewers assisted consecutive new patients to complete a pre- and post-consultation questionnaire seeking information on the presenting complaint, patient-reported reason for encounter (RFE), doctor-recorded health problem, treatments received, and patient expectations of and satisfaction with care. RESULTS The sample (n = 197) was young (mean age 33 years). A high proportion came from a low socioeconomic group (68%) and there was a higher than expected proportion of patients with a non-English speaking background (NESB) (53%). Three-quarters had a regular GP elsewhere. Important reasons for choosing this service were accessibility and familiarity: being part of a hospital: case of obtaining radiological examinations, and the quality of the doctors. The commonest health problem was trauma related (14-16%). The main body systems involved were locomotor, skin, digestive, respiratory, pregnancy related and non specific. Patients were mostly satisfied with their cares those with ill-defined problems were more likely to report that their expectation were not completely met. There were no significant demographic and ethnic variations in the outcome variables. CONCLUSIONS HBPCCs can complement the GP's ongoing relationship with patients from NESB and lower socioeconomic groups to improve the continuity and coordination of healthcare. Experienced and culturally sensitive GPs, good communications, and an effective and comprehensive interpreter service are necessary to facilitate this care coordination. One strategy is a hospital based department of general practice linking academic GPs and a local divisional network of GPs, to provide this clinical service and undertake teaching and research in the areas highlighted by this study.

UI MeSH Term Description Entries
D008297 Male Males
D008427 Maternal Health Services Organized services to provide health care to expectant and nursing mothers. Health Services, Maternal,Services, Maternal Health,Health Service, Maternal,Maternal Health Service
D010044 Outpatient Clinics, Hospital Organized services in a hospital which provide medical care on an outpatient basis. Ambulatory Care Facilities, Hospital,Hospital Outpatient Clinics,Clinic, Hospital Outpatient,Clinics, Hospital Outpatient,Hospital Outpatient Clinic,Outpatient Clinic, Hospital
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D005194 Family Practice A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. Family Practices,Practice, Family,Practices, Family
D005260 Female Females
D006301 Health Services Needs and Demand Health services required by a population or community as well as the health services that the population or community is able and willing to pay for. Health Services Needs,Needs,Needs and Demand, Health Services,Target Population,Health Services Need,Need, Health Services,Needs, Health Services,Population, Target,Populations, Target,Target Populations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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