2005-2019年英国初级保健的临床工作量趋势:一项回顾性队列研究
Lyvia de Dumast1, Patrick Moore2, Kym Ie Snell3
1Institute of Applied Health Research, University of Birmingham, Birmingham.
概括
在2014年之前,英国的初级保健体验了临床工作量和咨询时间的增加. 2015年后,需求增加和行政任务压缩了产能,表明系统接近和.
科学领域:
- 初级医疗保健研究 研究初级医疗保健研究
- 医疗保健服务研究 医疗服务研究
- 一般实践 工作量分析 工作量分析
背景情况:
- 从2007年至2014年,英国初级保健部门的咨询费率,持续时间和工作量大幅增加.
- 之前的分析没有涵盖临床工作量最近的趋势.
- 本研究检查了由于人口发病率导致的初级医疗保健需求的变化.
研究的目的:
- 从2005年起,记录英国初级保健临床工作负载的变化.
- 分析全科医生 (GP) 和实践护士咨询费率和持续时间的趋势.
- 评估慢性疾病患病率对初级保健工作量的影响.
主要方法:
- 一项回顾性队列研究,利用来自英国824家全科医院的电子健康记录.
- 来自IQVIA医学研究数据的5亿多个匿名患者记录的分析.
- 计算每人/年患者级工作量,包括直接和间接的GP工作量.
主要成果:
- 从2014年到2019年,年龄标准化GP直接咨询率每年下降2.0% .
- 总体而言,全科医生直接咨询率下降了5.8% (2005-2019),但平均每人每年的工作量增加了25.8%.
- 平均咨询时间增加了36.9%,间接GP工作量增加了近三倍,患有≥3种慢性疾病的患者比例增加到16.1%.
结论:
- 临床工作量,咨询率和持续时间增加到2014年.
- 自2015年以来,不断增长的医疗保健需求和行政负担造成了能力限制.
- 英国的初级保健系统由于持续的工作负载压力而接近和.
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