OBJECTIVES:

Strong primary care in a healthcare system, with a greater focus on prevention and early management of health problems, is considered to provide better quality care and expected to reduce unnecessary hospital utilization. This study aimed to explore the relationship between patient experience of primary care and their utilization of hospital care in China.

METHODS:

Data was collected via one-to-one and face-to-face interview in 16 primary care settings in southern China. Patient experience of primary care was assessed using the Assessment Survey of Primary Care (ASPC) scale, which was comprised of six domains, including first-contact care, continuity, comprehensiveness, accessibility, coordination, and patient-centeredness. Patient utilization of hospital care was measured by patient-reported hospital admissions, hospital outpatient visits, and emergency department visits during the past six months. Spearman correlation analysis was employed to evaluate the association between the two variables. Logistic regression analysis was conducted to evaluate the impact of patient-perceived quality of primary care on patient utilization of hospital care.

RESULTS:

This study recruited a total of 1,185 patients, 398(33.6%) of whom reported utilization of hospital care during the past six months, while the remaining 787(66.4%) did not. Correlation analysis indicated that there was negative association between patient experience of primary care and their utilization of hospital care. Logistic regression analysis showed that the total score of patient experience of primary care had negative impact on the odds of patient utilization of hospital care(P<0.001), especially patient outpatient visits(P<0.001) and hospital admissions(P=0.029).

CONCLUSIONS:

Better patient experience of primary care was found to negatively impact patient utilization of hospital care in the past six months in China. To confirm findings of this study, future studies may consider using hospital audit data to further monitor the association between patient experience of primary care and their utilization of hospital care.