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The Effect of Access to Primary Care Physicians on Avoidable Hospitalizations: A Time Series Study in Rural Areas of Tehran Province, Iran

Korean Journal of Family Medicine 2020년 41권 5호 p.282 ~ 290
Rashidian Arash, Salavati Sedigheh, Hajimahmoodi Hanan,
소속 상세정보
 ( Rashidian Arash ) - Tehran University of Medical Sciences School of Public Health Department of Health Management and Economics
 ( Salavati Sedigheh ) - Maragheh University of Medical Sciences School of Nursery Department of Public Health
 ( Hajimahmoodi Hanan ) - Iran Health Insurance Organization Department of Family Physician Program

Abstract


Background: Avoidable hospitalizations (AHs) are defined as hospitalizations that could have been prevented through timely and effective services. AHs are, therefore, an indicator used to evaluate the access and effectiveness of primary health care services.

Methods: A retrospective time-series study spanning 8 years (2006?2013) was conducted to determine the relationship between AHs and gender, age, and access to primary health care physicians in rural areas in Tehran province, the capital of Iran. The total number of avoidable hospitalizations was 22,570; logistic regression was estimated for each year separately.

Results: Total hospitalizations and AHs increased during the study period, especially during the first 3 years of the study. AHs, as a percentage of total hospitalizations, did not change significantly throughout the study years. This value was 22.3% during the first year of study and varied between 17% and 19.6% from 2007 to 2013. No statistically significant relationship was seen between AH occurrence and access to a physician during the study years.

Conclusion: Increasing access to primary health care physicians cannot necessarily result in decreased AHs. Considering the factors influencing AHs while designing and implementing the family physicians program is important to achieve the expected results regarding the effectiveness of primary health care services.

키워드

Primary Health Care; Physicians; Avoidable Hospitalization; Rural Health; Health Insurance

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