Relationship between the presence of primary care physicians and health‐related quality of life

Abstract

Abstract Background The supply of primary care physicians is associated with better health outcomes and a lower total cost of health services. However, the effect of the presence or absence of primary care physicians on health‐related quality of life (QOL) is unknown. We comparatively investigated the health‐related QOL of ordinary citizens according to the presence or absence of a primary care physician. Methods We conducted an observational cross‐sectional study using a propensity score analysis. A questionnaire on health‐related QOL (SF‐36v2, age, gender, presence or absence of a primary care physician, and chronic disease status) was mailed to 2200 individuals identified through stratified random sampling. We used propensity scores to compensate for covariates and analyzed three component SF‐36 summary scores and subscale scores of the “primary care physician” and “no primary care physician” groups. Results Valid responses were received from 1095 individuals (49.8%). The “primary care physician group” comprised 653 individuals (59.6%). The physical health component scores of the “primary care physician group” were significantly lower than those of the “no primary care physician group,” and the “mental health component” scores were significantly higher (p = 0.032, p = 0.009). For the subscales, scores for “vitality” and “mental health” were significantly higher in the “primary care physician group” (p = 0.014, p = 0.018). Conclusions Patients who had a primary care physician with whom they could comfortably consult at any time had a high mental health component score, and low physical health component score in the health‐related QOL.

Keywords

• health policy
• health services research
• primary care issues
• social factors in health