Population-level Preferences for Primary Care Physicians Characteristics in Japan: A Structural Equation Modeling
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概要
- 論文の詳細を見る
Objective Primary care has potential to play a role for improving the patient care in Japanese health care system; however, little information is available about how patients perceive the roles of primary care physicians (PCPs) within the Japanese health care system. We aimed to assess population-level preferences for PCPs and investigated the extent to which preferences vary in relation to different population groups in Japan. Methods Data were extracted from a cross-sectional questionnaire survey in October 2003. An 18-item questionnaire was used to measure the preferences for PCPs. Exploratory factor analysis was performed to identify latent factors, while confirmatory factor analysis was used to evaluate the fit of the structure using structural equation modeling (SEM). Patients Nationally representative sample of the adult Japanese general population was chosen by controlling for age, sex, and the size of cities. Results A total of 2,453 adults ≥18-years-old were analyzed. SEM provided a 4-factor structural model of the population-level preference for PCPs, such as clinical competence (path coefficient (pc)=0.72), gate-keeping (pc=0.64), communication with patients or specialists (pc=0.49) and high education (pc=0.25) and demonstrated the best goodness-of-fit. Those who were middle aged, have a high family income, and a high level of education, placed more importance on gate-keeping characteristics, and the rural residents emphasized communication rather than clinical competence. Conclusion Our results indicate that the preferences for PCPs are divided into four main factors and underscore the variation among preferences according to different population groups, such as age, socioeconomic and educational status, and places of living. These variations should be considered to improve the primary care system in Japan.
著者
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Fukui Tsuguya
聖路加国際病院 一般内科
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Tokuda Yasuharu
聖路加国際病院 一般内科
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Takahashi Osamu
Division of General Internal Medicine, Department of Medicine, St. Lukes International Hospital
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Ohde Sachiko
St. Lukes Life Science Institute
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Jacobs Joshua
Office of Medical Education, Department of Medicine, University of Hawaii
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Tokuda Yasuharu
Mito Medical Center, University of Tsukuba Hospital, Institute of Clinical Medicine, Graduate School
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Yanai Haruo
St. Lukes Graduate School of Nursing
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Okubo Tomoya
The National Center for University Entrance Examinations
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Shimbo Takuro
Research Institute, International Medical Center of Japan
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Fukuhara Shunichi
Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and
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Hinohara Shigeaki
St. Lukes Life Science Institute
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Fukui Tsuguya
Division of General Internal Medicine, Department of Medicine, St. Lukes International Hospital
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Ohde Sachiko
St. Luke's Life Science Institute
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Shimbo Takuro
聖路加国際病院 一般内科
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Shimbo Takuro
Research Institute International Medical Center Of Japan
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Okubo Tomoya
聖路加国際病院 一般内科
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Fukuhara Shunichi
聖路加国際病院 一般内科
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Hinohara Shigeaki
St. Luke's International Hosp.
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Yanai Haruo
St. Luke's College Of Nursing
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Fukuhara Shunichi
Department Of Epidemiology & Healthcare Research Kyoto University
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Tokuda Yasuharu
Mito Kyodo Hospital University Of Tsukuba
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Takahashi Osamu
Division Of Cancer Medicine Department Of Surgical Oncology Hokkaido University Graduate School Of M
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Fukui Tsuguya
Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital
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Tokuda Yasuharu
Mito Medical Center, University of Tsukuba Hospital, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba
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Hinohara Shigeaki
St. Luke's Life Science Institute
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