关于初级保健医生中低价值护理和退出实施障碍的观点:一项跨国调查
Aleksi Raudasoja1,2, Kari A O Tikkinen3,4,5, Benedetta Bellini6
1Faculty of Medicine, University of Helsinki, Helsinki, Finland. raudasoja.aleksi@gmail.com.
BMC primary care
|May 9, 2024
概括
高收入国家的初级保健医生认识到过度诊断和过度治疗是重要的医疗保健问题. 减少低价值护理的主要障碍包括患者的期望,对医疗错误的恐惧和时间限制.
科学领域:
- 医疗保健政策 医疗保健政策
- 主要护理药物 医疗保健药物
- 卫生经济学 卫生经济学
背景情况:
- 全球医疗保健成本不断上升,需要减少无效或有害的治疗方法.
- 医疗保健的很大一部分没有任何好处,甚至可能对患者造成伤害.
- 了解医生的态度和障碍对于消除低价值护理至关重要.
研究的目的:
- 探索初级保健医生对低价值护理的态度.
- 识别阻碍高收入国家不再实施低价值护理的障碍.
主要方法:
- 在2022年5月至6月期间,向六个高收入国家 (奥地利,芬兰,希腊,意大利,日本,瑞典) 的初级保健医生发送了一份电子邮件调查.
- 该调查评估了对明智选择建议的熟悉程度,对过度诊断/过度治疗的态度,以及停止实施的障碍.
- 用描述性统计数据分析了来自1,505名符合条件的受访者的数据.
主要成果:
- 超过80%的医生认为过度诊断和过度治疗是全国性的问题,而在他们自己的实践中,这一比例约为50%.
- 患者的期望 (85%),测试/治疗的要求 (83%),对医疗错误的恐惧 (81%),工作量 (81%) 和对诊断不足的恐惧 (79%) 被确定为主要障碍.
- 各国之间观察到的态度和感知障碍的显著差异.
结论:
- 医生承认过度诊断和过度治疗是国家问题,但在自己的实践中不那么深刻地感知到它们.
- 退出实施的常见障碍包括时间限制,对错误的恐惧和患者驱动的需求.
- 根据当地环境和障碍量身定制退出实施策略对于有效的医疗保健改革至关重要.
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