Do patients bypass primary care for common health problems under a free-access system? Experience of Taiwan

Liang, Li-Lin; Huang, Nicole; Shen, Yi-Jung; Chen, Annie Yu-An; Chou, Yiing-Jenq

doi:10.1186/s12913-020-05908-w

BMC Health Services Research

Table 3 Logistic regressions for the likelihood of bypass: all visits

From: Do patients bypass primary care for common health problems under a free-access system? Experience of Taiwan

	Diabetes				Hypertension				Common cold
Predictors	OR^a	SE^b	P	95% CI	OR	SE	P	95% CI	OR	SE	P	95% CI
Age	1.00	0.00	0.037	1.00–1.00	1.00	0.00	< 0.001	1.00–1.00	0.98	0.00	< 0.001	0.98–0.98
Female	0.93	0.01	< 0.001	0.91–0.95	0.95	0.01	< 0.001	0.93–0.97	0.92	0.01	< 0.001	0.89–0.95
Socioeconomic status, NTD
< 20,000	1.00	ref^c			1.00	ref			1.00	ref
20,000-39,999	0.98	0.02	0.403	0.94–1.03	0.95	0.02	0.009	0.92–0.99	1.22	0.03	< 0.001	1.16–1.28
≥ 40,000	1.14	0.03	< 0.001	1.09–1.20	1.12	0.02	< 0.001	1.08–1.17	1.43	0.04	< 0.001	1.36–1.51
Farmers and fishers	0.84	0.02	< 0.001	0.80–0.88	0.78	0.02	< 0.001	0.75–0.81	1.25	0.04	< 0.001	1.18–1.33
Others	1.06	0.03	0.015	1.01–1.11	1.09	0.02	< 0.001	1.05–1.13	1.96	0.05	< 0.001	1.86–2.07
Comorbidities
Diabetes	n/a	n/a	n/a	n/a	1.31	0.02	< 0.001	1.28–1.34	1.21	0.06	< 0.001	1.10–1.33
Hyperlipidemia	1.30	0.01	< 0.001	1.27–1.33	1.88	0.02	< 0.001	1.84–1.91	1.11	0.04	0.012	1.02–1.20
Hypertension	1.13	0.01	< 0.001	1.11–1.16	n/a	n/a	n/a	n/a	2.10	0.08	< 0.001	1.96–2.25
Coronary artery disease	1.12	0.02	< 0.001	1.08–1.15	1.61	0.02	< 0.001	1.57–1.65	1.49	0.08	< 0.001	1.35–1.65
Cerebrovascular disease	1.67	0.04	< 0.001	1.59–1.74	1.96	0.04	< 0.001	1.89–2.03	2.43	0.15	< 0.001	2.15–2.75
COPD^d	1.26	0.04	< 0.001	1.18–1.34	1.54	0.04	< 0.001	1.47–1.61	3.64	0.18	< 0.001	3.30–4.01
Asthma	0.80	0.04	< 0.001	0.73–0.87	1.08	0.04	0.025	1.01–1.15	5.35	0.17	< 0.001	5.03–5.70
Chronic liver disease	1.19	0.02	< 0.001	1.15–1.23	1.19	0.02	< 0.001	1.15–1.24	1.55	0.09	< 0.001	1.38–1.75
Chronic kidney disease	1.45	0.03	< 0.001	1.38–1.51	1.74	0.04	< 0.001	1.66–1.82	1.88	0.14	< 0.001	1.62–2.18
Geographical area
Taipei	1.00	ref			1.00	ref			1.00	ref
North	0.93	0.02	< 0.001	0.90–0.96	0.91	0.01	< 0.001	0.89–0.94	0.90	0.03	< 0.001	0.85–0.95
Central	0.89	0.01	< 0.001	0.86–0.92	0.78	0.01	< 0.001	0.76–0.80	1.18	0.03	< 0.001	1.13–1.24
South	1.01	0.02	0.455	0.98–1.05	0.96	0.01	0.005	0.93–0.99	1.13	0.03	< 0.001	1.07–1.19
Kao-Ping	0.87	0.02	< 0.001	0.84–0.90	0.83	0.01	< 0.001	0.81–0.85	0.88	0.03	< 0.001	0.83–0.93
East	0.51	0.02	< 0.001	0.47–0.54	0.56	0.02	< 0.001	0.53–0.59	1.66	0.07	< 0.001	1.53–1.81
Number of physicians practicing in academic medical centers and regional hospitals (per 10,000 residents)	1.12	0.00	< 0.001	1.11–1.12	1.11	0.00	< 0.001	1.11–1.12	1.10	0.00	< 0.001	1.09–1.10
Number of physicians practicing in community hospitals and clinics (per 10,000 residents)	0.92	0.00	< 0.001	0.92–0.93	0.95	0.00	< 0.001	0.94–0.95	1.02	0.01	0.015	1.00–1.03
Year
2000	1.00	ref			1.00	ref			1.00	ref
2005	0.98	0.02	0.423	0.95–1.02	0.88	0.01	< 0.001	0.85–0.91	0.73	0.02	< 0.001	0.70–0.77
2010	0.89	0.02	< 0.001	0.86–0.93	0.70	0.01	< 0.001	0.68–0.72	0.67	0.02	< 0.001	0.63–0.70
2015	0.76	0.02	< 0.001	0.73–0.79	0.61	0.01	< 0.001	0.59–0.63	0.56	0.02	< 0.001	0.53–0.59
2017	0.72	0.02	< 0.001	0.69–0.75	0.50	0.01	< 0.001	0.48–0.51	0.52	0.02	< 0.001	0.49–0.56

Note: The sample size (number of visits) for diabetes, hypertension, and common cold was 172,944, 308,743, and 1,389,726, respectively. The dependent variable was dichotomous (1 = visited medical centers or regional hospitals; 0 = visited community hospitals or clinics). ^a OR: Odds Ratio. ^b SE: Standard Errors. ^c ref.: reference category. ^d COPD: Chronic Obstruction Pulmonary Disease

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