Positive association between patient experience of primary care with chronic disease and self-rated health in a Japanese rural area: A cross-sectional questionnaire survey using the Japanese primary care assessment tool short form.

Background: Low birthrates and an aging society during population decline have brought about labor shortages and increased medical care needs. Medical resources should be distributed appropriately, particularly in rural areas. High-quality primary care can make the medical system more effective and contribute to rural residents' health. However, there are no reports on the impact of primary care on health in the rural areas of Japan. This study examined the effect of primary care quality on self-rated health in a rural Japanese area. Methods: We conducted a cross-sectional study using a questionnaire survey of residents of a rural area in northern Shiga Prefecture in 2021. Self-rated health (SRH) was used as the health outcome (1-5 points), and the Japanese Primary Care Assessment Tool Short Form (JPCAT-SF) was used to measure the patients' experience of primary care (0-100 points). We conducted a multivariate analysis using logistic regression analysis and examined the association between good SRH (4 points or more) and high JPCAT-SF scores (above average score), adjusted for sociodemographic confounding factors. Results: A total of 1108 men and 1412 women responded to the survey. The mean patient age was 69.8 years. The mean JPCAT-SF score was 51.8 points. Among the 1172 patients with chronic diseases, good SRH was associated with high JPCAT-SF scores (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.009-1.73). Conclusions: Good SRH among rural residents with chronic disease was associated with high primary care quality.