Background
Method
Outcome measures
Data analysis
Results
Total* | RFD | ORD | NRD | |
---|---|---|---|---|
(n = 3148) | (n = 1150) | (n = 746) | (n = 1157) | |
Age (mean ± s.d.) † | 40.2 ± 18.1 | 38.5 ± 17.6 | 40.1 ± 18.0 | 41.3 ± 18.5 |
<25 yrs (%) | 23.0 | 21.9 | 23.8 | 24.1 |
25-64 yrs (%) | 68.0 | 72.8 | 67.4 | 63.9 |
≥65 yrs (%) | 9.0 | 5.3 | 8.7 | 12.0 |
Male (%) | 40.9 | 38.1 | 39.4 | 44.9 |
Married (%) | 54.9 | 57.1 | 53.6 | 53.2 |
Education ≤ primary school (%) | 17.4 | 13.4 | 17.1 | 20.7 |
Household income < HKD$20,000 (%) †‡ | 53.1 | 42.0 | 52.0 | 64.1 |
Occupation (%) | ||||
Managerial/ Admin/ Professionals/ Employer | 12.5 | 15.9 | 12.3 | 9.7 |
White collar workers | 16.5 | 19.5 | 17.5 | 13.0 |
Blue collar/ Service sales worker | 20.4 | 17.4 | 21.7 | 23.0 |
Chronic disease (%) | 34.7 | 34.8 | 38.2 | 30.8 |
Long term medications (%) | 22.8 | 23.7 | 25.1 | 19.5 |
General Health condition (%) | ||||
Excellent/Very good/Good | 48.7 | 53.2 | 41.3 | 50.0 |
Fair | 44.9 | 42.3 | 49.2 | 44.3 |
Poor | 6.4 | 4.3 | 9.5 | 5.8 |
Independent variables | Odds ratio | 95% CI | P-value |
---|---|---|---|
Age | 0.987 | ( 0.978 - 0.997 ) | 0.010 |
Sex (male) | 1.204 | ( 0.974 - 1.488 ) | 0.087 |
Marital status (single/ divorced/ widower) | 0.044 | ||
– Married | 1.333 | ( 1.047 - 1.697 ) | 0.019 |
– Refuse to answer | 0.741 | ( 0.239 - 2.300 ) | 0.604 |
Educational level (nil/ primary) | 0.092 | ||
– Secondary | 1.319 | ( 1.008 - 1.725 ) | 0.043 |
– Tertiary | 1.082 | ( 0.774 - 1.512 ) | 0.645 |
– Refuse to answer | 0.765 | ( 0.245 - 2.391 ) | 0.645 |
Household monthly income (< $5,000) | <0.001 | ||
– $5,000 - $9,999 | 0.868 | ( 0.551 - 1.369 ) | 0.543 |
– $10,000 - $19,999 | 1.487 | ( 0.970 - 2.279 ) | 0.069 |
– $20,000 - $29,999 | 2.243 | ( 1.422 - 3.537 ) | <0.001 |
– $30,000 - $39,999 | 2.594 | ( 1.583 - 4.252 ) | <0.001 |
– ≥ $40,000 | 3.384 | ( 2.108 - 5.432 ) | <0.001 |
– Refuse to answer | 2.056 | ( 1.311 - 3.224 ) | 0.002 |
Occupation (blue-collar worker/ service and sales worker) | 0.010 | ||
– Managerial/ administrative/professional/ employer | 1.362 | ( 0.953 - 1.946 ) | 0.090 |
– White-collar worker | 1.525 | ( 1.116 - 2.084 ) | 0.008 |
– Student | 1.057 | ( 0.713 - 1.568 ) | 0.781 |
– Home-maker | 1.142 | ( 0.825 - 1.581 ) | 0.423 |
– Retired/ unemployed | 0.746 | ( 0.518 - 1.074 ) | 0.115 |
– Others | 0.961 | ( 0.446 - 2.074 ) | 0.920 |
Chronic disease (yes) | 0.738 | ( 0.573 - 0.950 ) | 0.018 |
Long term medication (yes) | 0.559 | ( 0.415 - 0.753 ) | <0.001 |
General Health Condition (poor) | 0.467 | ||
– Excellent | 1.333 | ( 0.727 - 2.444 ) | 0.353 |
– Very good | 1.572 | ( 0.966 - 2.557 ) | 0.069 |
– Good | 1.381 | ( 0.865 - 2.206 ) | 0.177 |
– Fair | 1.358 | ( 0.874 - 2.110 ) | 0.173 |
Smoking (yes) | 1.206 | ( 0.938 - 1.551 ) | 0.144 |
Drinking (yes) | 1.139 | ( 0.932 - 1.393 ) | 0.203 |
Regular exercise (no/ don’t know) | 1.372 | ( 1.131 - 1.665 ) | 0.001 |
Prevalence (Likelihood) of health services utilization
Last episode of illness | Total | RFD | ORD | NRD |
---|---|---|---|---|
(n = 3148) | (n = 1150) | (n = 746) | (n = 1157) | |
Had consulted any doctors (%)*†‡ | 71.7 | 80.2 | 74.7 | 60.8 |
▪ Had used any Western doctor (%)*†‡ | 65.4 | 77.6 | 68.1 | 51.3 |
-- Consulted family doctor (%)*†‡ | 30.2 | 67.0 | 10.6 | 7.0 |
-- Consulted regular PC doctor who is not a family doctor (%)†‡ | 27.5 | 16.8 | 54.7 | 19.4 |
-- Consulted other doctors (%)*† | 19.7 | 14.3 | 13.1 | 29.0 |
▪ Consulted Chinese medicine practitioner (%) | 12.1 | 13.1 | 13.1 | 10.6 |
▪ Visited emergency service (%)*‡ | 7.3 | 4.3 | 7.8 | 9.6 |
▪ Admitted to the hospital (%)*‡ | 3.1 | 1.7 | 3.6 | 4.0 |
Health service utilization rate
Total | RFD | ORD | NRD | |
---|---|---|---|---|
(n = 3148) | (n = 1150) | (n = 746) | (n = 1157) | |
mean ± s.d, (% of subjects) | ||||
Monthly consultation rate*†
| 0.71 ± 1.53 | 0.85 ± 1.73 | 0.85 ± 1.60 | 0.49 ± 1.26 |
(33.6%) | (39.1%) | (38.3%) | (25.2%) | |
- Western medicine doctors*†‡ | 0.43 ± 1.00 | 0.61 ± 1.22 | 0.50 ± 1.06 | 0.20 ± 0.62 |
(24.7%) | (33.6%) | (28.5%) | (13.5%) | |
- Western medicine family doctors*†‡ | 0.21 ± 0.75 | 0.50 ± 1.10 | 0.06 ± 0.41 | 0.03 ± 0.26 |
(12.8%) | (30.1%) | (3.5%) | (2.0%) | |
- Western medicine regular but not family doctors*†‡ | 0.22 ± 0.65 | 0.11 ± 0.40 | 0.44 ± 0.98 | 0.17 ± 0.56 |
(14.4%) | (8.9%) | (26.1%) | (11.9%) | |
- Chinese medicine practitioner*†‡ | 0.24 ± 1.03 | 0.24 ± 1.04 | 0.32 ± 1.12 | 0.19 ± 0.97 |
(9.6%) | (10.0%) | (12.5%) | (7.5%) | |
- Hospital emergency service†‡ | 0.06 ± 0.45 | 0.05 ± 0.56 | 0.08 ± 0.47 | 0.05 ± 0.29 |
(3.7%) | (2.3%) | (5.2%) | (3.8%) | |
Monthly Hospital admission rate
| 0.01 ± 0.14 | 0.01 ± 0.14 | 0.02 ± 0.15 | 0.01 ± 0.13 |
(1.2%) | (1.0%) | (1.3%) | (1.1%) |
Effects of primary care doctor choice on health service utilization
Logistic regression results | RFD vs. NRD† | RFD vs. ORD† | ORD vs. NRD† | Other significant independent variables (p < 0.05)‡ | |
---|---|---|---|---|---|
Overall significance | Odds ratio (95% C.I.) | ||||
Any primary care doctor consultation | 0.012 | *2.486 | *1.342 | *1.853 | Drinking, regular exercise, occupation, marital status |
(2.053,3.010) | (1.074,1.676) | (1.509,2.275) | |||
Emergency service visit | <0.001 | *0.479 | *0.624 | 0.768 | Age, general health, long-term medication, household monthly income, district |
(0.330,0.695) | (0.411,0.949) | (0.536,1.098) | |||
Hospital admission | 0.032 | *0.458 | *0.514 | 0.891 | Age, long-term medication |
(0.267,0.788) | (0.284,0.932) | (0.540,1.470) |
RFD vs NRD† | RFD vs ORD† | ORD vs NRD† | Other significant independent variables (p < 0.05)‡ | ||
---|---|---|---|---|---|
Overall significance | Coefficient (95% C.I.) | ||||
Negative Binomial Regression Results
| |||||
Monthly consultation rate | <0.001 | *0.473 | 0.046 | *0.427 | Seasonality, sex, general health, chronic disease, drinking, occupation, educational level, district |
(0.332,0.614) | (−0.098,0.191) | (0.273,0.581) | |||
Poisson Regression Results
| |||||
Monthly emergency service visit rate | 0.158 | 0.253 | −0.099 | 0.352 | Seasonality, sex, age, general health, long-term medication, occupation, household monthly income, educational level, district |
(−0.140,0.647) | (−0.490,0.292) | (−0.038,0.742) | |||
Monthly hospital admission rate | 0.360 | −0.047 | −0.253 | 0.206 | Seasonality |
(−0.764,0.670) | (−1.013,0.507) | (−0.553,0.965) |