Clinical trial NCT01422031: Study on Primary Care Health Service Utilization in Hong Kong
Official title: Utilization Pattern of Primary Health Care Services in Hong Kong - Does Having a Family Doctor Make Any Difference?
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Primary Care
Health Services Utilization
Family Practice
Keywords: Primary care
Family doctor
Consultation
utilization
Non-drug managements
Patient enablement index
Lead sponsor: The University of Hong Kong
Sponsor class: OTHER
Collaborators: name: Food and Health Bureau, Hong Kong
First posted: 2011-08-23
Enrollment: 3148
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: 5174 eligible households were contacted by telephone but 1532 refused to be interviewed and 494 did not complete the interview. 3148 (60.8%) subjects, with 1616 and 1532 in the first and second phases, respectively, completed the cross-sectional survey. 1131 people (480 by additional telephone sampling) were invited to the longitudinal study but only 708 eventually agreed to take part and 327 returned the diaries (all by completion). 319 subjects had complete cross-sectional and longitudinal data for the final analysis.

Brief summary: The aim of this study was to find out the utilization rate and pattern of primary health care services, and the process and outcomes of primary care consultations of the general population in Hong Kong, and whether having a family doctor would make any difference.

The study objectives were to determine

1. the rates and pattern of utilization of different primary health care services and self-care
2. Patient self-reported outcomes (global rating on change in health, satisfaction and patient enablement) of primary care consultations;
3. the process of care in consultations including drug and non-drug managements, investigations, preventive care and referrals;
4. the effect of having a regular family doctor on service utilization rate and pattern, health promotion practice, and process and outcomes of primary care consultations.

Detailed description: Study Design: A Cross-sectional general population survey and a longitudinal study (12-weeks follow up)

Method: Two phases, corresponding to Summer and Winter, respectively, of cross-sectional telephone survey on the Hong Kong general population using a structured questionnaire to collect information on the choice primary care doctors, illness rates, primary care service utilization rates and self-reported process and outcomes of consultations. A longitudinal study for 12 weeks was carried out on a sub-sample of the cross-sectional study subjects to collect data to cross-validate cross-sectional data. Univariate and multivariate regression analyses were used to determine whether there was any difference in service utilization rates, process and outcomes among people using different types of primary care doctors.

Eligibility criteria: Inclusion Criteria:

* Written consent to study

Exclusion Criteria:

* Non-residential numbers
* Inability to communicate in Cantonese, Putonghua or English
* Refusal to telephone interview
* No contact after 5 attempts

Primary outcomes:
measure: Primary care doctor choice group
timeFrame: baseline
measure: Monthly utilization rate
timeFrame: Baseline
measure: Patient Enablement Instrument (PEI)
timeFrame: Baseline
measure: Rates of non-drug managements
timeFrame: Baseline
Secondary outcomes:
measure: Doctor shopping rate
timeFrame: Baseline
measure: Self-medication rates during the last episode of illness
timeFrame: Baseline
measure: Prescribing rate during last episode of illness
timeFrame: Baseline
measure: Prevalence of preventive care
timeFrame: Baseline
measure: Self-perceived health score
timeFrame: Baseline
measure: Patient satisfaction
timeFrame: Baseline
Other outcomes:
Locations:
city: Hong Kong
country: China
facility: Family Medicine Unit, Faculty of Medicine, HKU
state: Hong Kong
Study officials:
affiliation: Family Medicine Unit, Faculty of Medicine, HKU
name: Cindy L.K. Lam, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lam CL, Leung GM, Mercer SW, Fong DY, Lee A, Lam TP, Lo YT. Utilisation patterns of primary health care services in Hong Kong: does having a family doctor make any difference? Hong Kong Med J. 2011 Jun;17(3 Suppl 3):28-32. No abstract available.
citation: Lam CL, Yu EY, Lo YY, Wong CK, Mercer SM, Fong DY, Lee A, Lam TP, Leung GM. Having a Family Doctor is Associated with Some Better Patient-Reported Outcomes of Primary Care Consultations. Front Med (Lausanne). 2014 Sep 15;1:29. doi: 10.3389/fmed.2014.00029. eCollection 2014.
citation: Fung CS, Wong CK, Fong DY, Lee A, Lam CL. Having a family doctor was associated with lower utilization of hospital-based health services. BMC Health Serv Res. 2015 Jan 28;15:42. doi: 10.1186/s12913-015-0705-7.