Korean J Fam Med.  2011 Feb;32(2):104-111. 10.4082/kjfm.2011.32.2.104.

Association between Primary Care Quality and Health Behaviors in Patients with Essential Hypertension Who Visit a Family Physician as a Usual Source of Care

• Park JH
• Kim KW
• Sung NJ
• Choi YG
• Lee JH
• Korean Primary Care Research Group

• KMID: 2304311
• DOI: http://doi.org/10.4082/kjfm.2011.32.2.104

Abstract

BACKGROUND
Management of hypertension has been performed mainly in primary care institutions, but hypertension control in population is still unsatisfactory. This study was aimed at finding a strategy to improve health promotion activities in patients with hypertension by exploring the association between health behaviors and quality of primary care.
METHODS
April to June in 2007, a questionnaire survey of the patients who has a family physician as a usual source of care was conducted for the development of the Korean Primary Care Assessment Tool (KPCAT). In this study, a usual source of care was defined as a physician of the persons who had visited their primary care clinic on six or more occasions over a period of more than 6 months. Of the data collected from 9 private clinics (3 in Seoul and 6 at small cities), cases of the patients who marked on having hypertension were selected. The associations between levels of quality of primary care and socio-demographic characteristics or health behaviors were analysed by Student t-test and chi-square test. Controlling socio-demographic variables, the association between quality of primary care and health behaviors was examined by multiple logistic regression analysis.
RESULTS
Among the patients (n = 602) of 9 private clinics who has a family physician as a usual source of care, those who marked on having hypertension were 134. Among 5 domains of the KPCAT, the highest domain in score was personalized care (71.7/100), and the lowest domain in score was coordination function (49.7/100). In patients who gave total average (69.2/100) or more in total primary care score, after adjustment with age, sex, income, education, and duration, odds ratio to have a normal BMI (<25 kg/m2) was 2.53 (P = 0.02), and odds ratio to have a habit drinking an adequate amount of alcohol was 4.32 (P = 0.02).
CONCLUSION
The fact that high-quality primary care was associated with good health behaviors in this study suggests that improving quality of primary care by health care reform can make health behaviors more desirable in patients with essential hypertension.

Keyword

Usual Source of Care; Hypertension; Life Style; Primary Care; Korean Primary Care Assessment Tool

MeSH Terms

Drinking
Health Behavior
Health Care Reform
Health Promotion
Humans
Hypertension
Life Style
Logistic Models
Odds Ratio
Physicians, Family
Primary Health Care
Surveys and Questionnaires