拒绝的代价:全科医生在病缺证书中的关门角色
Eivor Hovde Hoff1,2,3,4, Kristian B Kraft5,6, Cathrine F Moe7,8
1Norwegian Institute of Public Health (NIPH), Cluster for Health Services Research, Postboks 222, Skøyen, Oslo, N-0213, Norway. eivorhovde.hoff@fhi.no.
BMC public health
|February 12, 2024
概括
挪威的全科医生很少拒绝病假请求,患者的偏好对决策有很大的影响. 他们在疾病认证中的守门员角色主要仅限于谈判缺席的持续时间和强度.
科学领域:
- 职业健康 职业健康 职业健康
- 医疗保健服务研究 医疗服务研究
- 医学社会学 医学社会学
背景情况:
- 在挪威,全科医生在疾病保险体系中扮演着关键的守门角色.
- 服务费模式激励了短暂的咨询,这可能会影响门卫职能.
- 一般医生有责任限制获得带薪病假的机会,如果不是根据既定的标准来证明是合理的.
研究的目的:
- 探索挪威的全科医生 (GPs) 如何在疾病缺席认证中发挥他们的守门角色.
- 了解影响一般医生关于病假认证决定的因素.
主要方法:
- 使用6个焦点小组采访对33名全科医生的定性研究.
- 参与者来自挪威的不同地理区域,包括城市和农村地区.
- 布劳恩和克拉克的专题分析方法被用于数据分析.
主要成果:
- 一般医生的病名单决策主要取决于患者的需求和偏好.
- 一般医生很少拒绝患者的病假请求,即使他们认为这是不合理的或不有益的.
- 限制不合理病假的程度受全科医生的可用时间和患者冲突的感知风险的影响.
结论:
- 一般医生的疾病认证决定在很大程度上取决于患者的偏好.
- 一般医生在病假期间的守门职能受到限制,主要涉及到关于假期持续时间和强度的谈判.
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