在瑞典的初级医疗保健中实现患者-医生连续性:名医的重要性. 一个基于注册表的观察性研究
Lina Maria Ellegård1,2, Anders Anell3, Gustav Kjellsson4
1Department of Economics, Lund University, Lund, Sweden lina_maria.ellegard@nek.lu.se.
BJGP open
|May 28, 2024
概括
在慢性疾病开始时向指定全科医生 (GP) 注册患者并没有改善护理的连续性. 这种方法没有显著影响后续访问或患者的其他健康结果.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
- 慢性疾病管理 慢性疾病管理
背景情况:
- 持续的护理对于管理慢性疾病至关重要.
- 将患者分配给特定的全科医生 (GP) 可能会提高护理连续性.
研究的目的:
- 为了调查是否患者在他们的第一个慢性疾病发作时注册了名字的全科医生,显示出更大的护理连续性.
- 为了比较名字 GP 与那些只在实践中注册的患者的护理连续性.
主要方法:
- 在瑞典斯卡内县 (2009-2015) 进行基于注册表的观察性研究.
- 包括66,063名患有慢性疾病发病的患者.
- 在4年内比较通常的护理提供者 (UPC) 指数,根据患者和实践特征进行调整.
主要成果:
- 有名医生的患者在调整后显示UPC的轻微,非统计学显著增加.
- 对于慢性病的全科医生访问,护士访问,工作时间以外的访问,急诊室访问,入院或死亡率,没有发现显著差异.
- 患有姓名的全科医生的患者总体上有更多的访问,而不是专门针对他们的慢性疾病.
结论:
- 在诊断出第一个慢性疾病时,向名义上的全科医生注册并不能改善护理的连续性.
- 这种注册模式与慢性疾病患者的后续健康结果不相关.
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