Assessing the impact of socioeconomic determinants and management models on primary health care in Catalonia

评估社会经济因素和管理模式对加泰罗尼亚初级卫生保健的影响

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Abstract

OBJECTIVE: To assess the influence of management model and population's socioeconomic profile on two key outcomes in Catalonia's primary care: patient satisfaction and drug cost per user, aiming to support evidence-based reforms of the regional health system. DESIGN: Cross-sectional observational study. SITE: Primary care centers. PARTICIPANTS: People attended in primary care in Catalonia. INTERVENTIONS: None. MAIN MEASUREMENTS: Aggregated data about health and quality results summarized in a total of 19 indicators extracted from the 2023 Catalan Results Center dataset were analyzed. Descriptive, comparative, and multivariate linear regression analyses were applied. RESULTS: No significant associations were found between satisfaction or pharmaceutical spending and the management model or socioeconomic index. Patient satisfaction was primarily explained by experience-related variables, including accessibility, personal care, loyalty, and home care provision (adjusted R(2)=0.87). Pharmaceutical spending was associated with care intensity, as measured by the number of visits, polypharmacy, hypertension control, flu vaccination, and prescriptions per user (adjusted R(2)=0.73). CONCLUSIONS: The findings suggest that clinical and organizational factors are more influential than population characteristics or management models in determining outcomes in primary care. Reforms should focus on enhancing the patient experience, improving clinical efficiency, and adopting a humanistic approach to care delivery.

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