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Population-level preferences for primary care physicians' characteristics in Japan: a structural equation modeling
Osamu Takahashi1, Sachiko Ohde, Joshua L Jacobs
1Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, St. Luke's Graduate School of Nursing, Tokyo. otakahas@luke.or.jp
Internal Medicine (Tokyo, Japan)
|January 16, 2010
Summary
Japanese patients value primary care physicians (PCPs) for clinical competence, gate-keeping, communication, and education. Preferences for PCPs vary significantly across different age, income, education, and location demographics in Japan.
Area of Science:
- Health Services Research
- Primary Care Medicine
- Sociology of Health
Background:
- Primary care has the potential to improve patient care within the Japanese healthcare system.
- Limited information exists on Japanese patients' perceptions of primary care physicians' (PCPs) roles.
Purpose of the Study:
- To assess population-level preferences for PCPs in Japan.
- To investigate how these preferences vary among different demographic groups.
Main Methods:
- A nationally representative sample of 2,453 Japanese adults completed an 18-item questionnaire in 2003.
- Exploratory and confirmatory factor analyses using structural equation modeling (SEM) identified latent factors of PCP preference.
- Data were controlled for age, sex, and city size.
Main Results:
- SEM identified a four-factor model of PCP preferences: clinical competence (pc=0.72), gate-keeping (pc=0.64), communication (pc=0.49), and high education (pc=0.25).
- Middle-aged, high-income, and highly educated individuals prioritized gate-keeping.
- Rural residents emphasized communication over clinical competence.
Conclusions:
- PCP preferences in Japan are structured around four key factors.
- Significant variations in preferences exist based on age, socioeconomic status, education, and geographic location.
- These demographic variations must be considered to enhance Japan's primary care system.
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