退休或搬迁的全科医生及其与医疗保健使用和死亡率的关联:使用挪威国家数据的队列研究
Kristin Hestmann Vinjerui1, Andreas Asheim2,3, Kjartan Sarheim Anthun4
1Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway kristin.vinjerui@ntnu.no.
BMJ quality & safety
|July 26, 2024
概括
一般医生 (GP) 退休或搬迁导致患者医疗保健使用率增加,但没有影响死亡率. 这项研究强调了GP连续性对医疗保健利用的影响.
科学领域:
- 公共卫生 公共卫生
- 医疗保健管理的管理
- 流行病学 流行病学
背景情况:
- 一般医生 (GP) - 患者关系的连续性与改善的医疗保健结果有关.
- 关于永久性GP中断,如退休或搬迁对所有注册患者的影响的研究有限.
研究的目的:
- 为了检查挪威人口的医疗保健利用率和死亡率在常规GP退休或搬迁造成的不连续性后如何变化.
- 调查GP实践变化对患者健康结果的长期影响.
主要方法:
- 利用国家注册数据,比较退休或搬迁的全科医生与继续执业的全科医生患者的医疗保健使用率和死亡率.
- 包括在不连续性事件发生前三年与全科医生注册的患者,并在事件发生后长达五年跟踪他们.
- 使用差异差异设计与Poisson回归来评估随时间变化的变化.
主要成果:
- 在2011-2020年间,全科医生退休/搬迁影响了超过110万人.
- 在停诊后的第一年,全科医生白天接触人数增加了3%,急性医院接触人数增加了5%,持续长达五年.
- 在GP中断后的五年内,死亡率没有受到影响.
结论:
- 常规GP的退休或搬迁与他们列出的患者中医疗保健利用率的小到中等增加有关.
- 在GP退休或搬迁后,没有发现对患者死亡率的重大影响.
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