Table 3.
Differences in variables that measure the primary health care dimensions and sub-dimensions among the user populations of different health subsystems
| Variables, by primary health care dimensionsa and sub-dimensions | Public subsystem | Social security subsystem | Private subsystem | Significance level | |||||
|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | ||||
| Access to health care services | |||||||||
| Unmet health care needs | Required health care during the last 12 months | 263 | 83.5 | 311 | 86.6 | 106 | 83.5 | 0.466 | |
| Sought out health care each time he/she felt a health care need during the last 12 months (Q11)b | 239 | 91.2 | 294 | 94.5 | 100 | 94.3 | 0.209 | ||
| Abandoned health care seeking during the last 12 months (Q13) | 19 | 7.3 | 14 | 4.5 | 5 | 4.8 | 0.327 | ||
| Access to health care in populations with chronic conditions | Has been diagnosed with a chronic condition (Q7) | 64 | 20.3 | 117 | 32.6 | 35 | 27.6 | 0.002 | |
| Currently receiving treatment for chronic conditions (Q8) | 49 | 76.9 | 111 | 94.9 | 30 | 86.1 | 0.002 | ||
| Accommodation/ accessibility | Level of comfort with appointment system of his/her USC during the last 12 months (Q29) | Not at all or only somewhat comfortable | 97 | 32.8 | 47 | 13.5 | 10 | 8.1 | 0.000 |
| Moderately comfortable | 71 | 24.0 | 56 | 16.1 | 10 | 8.1 | |||
| Very or completely comfortable | 128 | 43.2 | 244 | 70.3 | 103 | 83.7 | |||
| Possibility of obtaining appointment in his/her USC by phone during the last 12 months (Q30) | Not at all or only somewhat possible | 210 | 77.5 | 48 | 14.1 | 7 | 5.8 | 0.000 | |
| Moderately possible | 18 | 6.6 | 36 | 10.6 | 12 | 10.0 | |||
| Very or completely possible | 43 | 15.9 | 257 | 75.4 | 101 | 84.2 | |||
| Ease of obtaining an appointment for an acute problem in his/her USC during the last 12 months (Q32) | Not at all or only somewhat easy | 54 | 20.1 | 33 | 11.4 | 18 | 15.1 | 0.000 | |
| Moderately easy | 105 | 39.0 | 100 | 34.6 | 31 | 26.1 | |||
| Very or completely easy | 110 | 40.9 | 156 | 54.0 | 70 | 58.8 | |||
| Ease of obtaining an appointment for a routine check-up in his/her USC during the last 12 months | Not at all or only somewhat easy | 34 | 12.8 | 26 | 8.5 | 7 | 7.3 | 0.000 | |
| Moderately easy | 103 | 38.7 | 91 | 29.6 | 26 | 27.1 | |||
| Very or completely easy | 129 | 48.5 | 190 | 61.9 | 63 | 65.6 | |||
| Number of days between the request for an acute problem and the visit, considering the last visit in his/her USMC | >week | 30 | 27.3 | 25 | 22.3 | 4 | 8.9 | 0.042 | |
| 2–7 days | 35 | 31.8 | 44 | 39.3 | 13 | 28.9 | |||
| Next day or same day | 45 | 40.9 | 43 | 38.4 | 28 | 62.2 | |||
| Time invested to obtain the last visit appointment in his/her USC among those who had to request one in person (Q50) | >1 hour | 19 | 10.4 | 9 | 3.7 | 3 | 3.9 | 0.000 | |
| 30 minutes to 1 hour | 39 | 21.4 | 26 | 10.6 | 6 | 7.8 | |||
| <30 minutes or by phone | 124 | 68.1 | 211 | 85.8 | 68 | 88.3 | |||
| Time spent in the waiting room prior to receiving health care during the last visit at his/her USC (Q51) | ≥1 hour | 55 | 21.2 | 40 | 12.9 | 14 | 14.0 | 0.014 | |
| 30 minutes < 1 hour | 64 | 24.6 | 56 | 18.0 | 22 | 22.0 | |||
| <30 minutes | 141 | 54.2 | 215 | 69.1 | 64 | 64.0 | |||
| Number of variables for which performance is high (over the mean) within those variables with significant differences | 0/9 | 8/9 | 9/9 | 9 | |||||
| Continuity of care | |||||||||
| Relational continuity | Currently has a USC, a place that she/he regularly or frequently uses each time that she/he needs medical care (affiliation) | 303 | 96.2 | 352 | 98.1 | 118 | 92.9 | 0.024 | |
| Has been seeking care at the USC for a year or more (Q17) | 271 | 88.3 | 321 | 90.7 | 109 | 86.5 | 0.155 | ||
| Is currently a regular patient of a particular physician at the USC (Q18) | 195 | 63.5 | 230 | 65.0 | 61 | 48.4 | 0.003 | ||
| Informational continuity based on last 12-month experience | How complete is her/his medical record at the USC (Q21) | Not at all or only somewhat complete | 15 | 6.3 | 19 | 6.4 | 12 | 13.8 | 0.004 |
| Moderately complete | 33 | 13.9 | 54 | 18.3 | 10 | 11.5 | |||
| Very or totally complete | 190 | 79.8 | 222 | 75.3 | 65 | 74.7 | |||
| Number of variables for which performance is high (over the mean) within those variables with significant differences | 3/3 | 2/3 | 0/3 | 3 | |||||
| Person-and-community-oriented care | |||||||||
| Whole-person care based on last 12 months experience | How well do the staff know her/ him at the USC (Q22) | Not at all or only somewhat well | 142 | 46.3 | 180 | 50.8 | 72 | 57.1 | 0.013 |
| Moderately well | 59 | 19.2 | 81 | 22.9 | 26 | 20.6 | |||
| Very or completely well | 106 | 34.5 | 93 | 26.3 | 28 | 22.2 | |||
| How possible would it be for the USC to contact her/him to go to her/his appointments (Q23) | Not at all or only somewhat possible | 187 | 60.9 | 260 | 73.4 | 99 | 78.6 | 0.000 | |
| Moderately possible | 53 | 17.3 | 57 | 16.1 | 18 | 14.3 | |||
| Very or completely possible | 67 | 21.8 | 37 | 10.5 | 9 | 7.1 | |||
| Population orientation based on last 12 months experience | Which phrase best describes your USC: it takes care of… | Visits or visits and patients | 171 | 55.7 | 274 | 77.4 | 101 | 80.2 | 0.000 |
| Patients and their families or patients and their families and communities | 136 | 44.3 | 80 | 22.6 | 25 | 19.8 | |||
| Participated in a community activity organized by the USC during the last 12 moths | 25 | 8.1 | 4 | 1.1 | 2 | 1.6 | 0.000 | ||
| How active the USC has been in seeking out solutions to community problems (Q28) | Not at all or only somewhat active | 382 | 69.0 | 539 | 77.2 | 195 | 79.3 | 0.000 | |
| Moderately active | 27 | 4.9 | 28 | 4.0 | 15 | 6.1 | |||
| Very or completely active | 145 | 26.2 | 131 | 18.8 | 36 | 14.6 | |||
| Number of variables for which performance is high (over the mean) within those variables with significant differences | 5/5 | 0/5 | 0/5 | 5 | |||||
| Health services utilization | |||||||||
| Annual consultation rate for population aged 18–64 years (Q37) | 3.1 | 2.9 | 3.1 | 0.528 | |||||
| Comprehensiveness | Health services used during the last 12 months (Q35) | General physician or specialist | 146 | 55.9 | 115 | 36.5 | 47 | 44.8 | 0.000 |
| General physician + specialist | 69 | 26.4 | 108 | 34.3 | 28 | 26.7 | |||
| At least general physician + specialist + dentist | 46 | 17.6 | 92 | 29.2 | 30 | 28.6 | |||
| Appropriateness of place and provider | Population whose USC is an emergency or after-hour service (Q16) | 13 | 4.2 | 29 | 8.2 | 29 | 23.4 | 0.000 | |
| Professional profile of her/his regular physician at her/his USC (Q19) | General physician | 183 | 93.3 | 191 | 83.0 | 53 | 86.9 | 0.006 | |
| Specialist | 13 | 6.7 | 39 | 17.0 | 8 | 13.1 | |||
| Number of variables for which performance is high (over the mean) within those variables with significant differences | 2/3 | 2/3 | 1/3 | 3 | |||||
USC, usual source of care; USMC, usual source of medical care.
aDimension definitions:
• Access to health care services: the ease with which the population is able to use appropriate services in proportion to their needs.
• Continuity of care: the degree to which a series of discrete health care events are experienced as coherent, connected and consistent with the patient’s medical needs and personal context.
• Person-and-community-oriented care: the extent to which primary care clinicians consider and respond to their patients’ physical, emotional and social needs considering their familiar and community context.
• Health services utilization: measures include type and degree of services used.
bThe number of questions is to identify only those variables included in the CATCPA.