title: The association between types of regular primary care and hospitalization among people with and without multimorbidity: A household survey on 25,780 Chinese.
abstract: Using data collected from 25,780 Hong Kong citizens in a household survey, this study aimed to investigate the association between having regular source of primary care and hospitalization amongst people with and without multimorbidity (two or more chronic conditions). Potential interaction effects of regular primary care with multimorbidity were also examined. Results revealed a significant association between having regular source of primary care from General Practitioners and reduced hospitalization amongst respondents with multimorbidity (RR = 0.772; 95% CI = 0.667-0.894), adjusting for other potential confounding factors (i.e., socio-demographic factors and medical insurance and benefits). In contrast, having regular Specialist care was significantly associated with increased risk of hospitalization among both people with multimorbidity (RR = 1.619; 95% CI = 1.256-2.087) and without multimorbidity (RR = 1.981; 95% CI = 1.246-3.149), adjusting for potential confounders. A dose-response relationship between the number of chronic diseases and hospitalization was also observed, regardless of whether participants had regular source of primary care or not; relative risks and predicted probabilities for hospitalization were generally greater for those without regular source of primary care. Further studies are warranted to explore the role of healthcare system, informatics, organizational and practice-related factors on healthcare and functional outcomes.
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Roger Y
authors.initials: RY
authors.lastname: Chung
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.|General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Scotland, UK.
authors.forename: Stewart W
authors.initials: SW
authors.lastname: Mercer
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Benjamin H K
authors.initials: BH
authors.lastname: Yip
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Stephanie W C
authors.initials: SW
authors.lastname: Chan
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Francisco T T
authors.initials: FT
authors.lastname: Lai
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.|School of Public Health, Sun Yat-Sen University, Guangzhou, P.R. China.
authors.forename: Harry H X
authors.initials: HH
authors.lastname: Wang
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Carmen K M
authors.initials: CK
authors.lastname: Wong
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Regina W S
authors.initials: RW
authors.lastname: Sit
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Eng-Kiong
authors.initials: EK
authors.lastname: Yeoh
authors.affiliation: School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Samuel Y S
authors.initials: SY
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002908:Chronic Disease / Q000453:epidemiology / Q000208:ethnology; D003695:Delivery of Health Care / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000076322:Multimorbidity; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult