[可能可以避免的医生办公室访问:一项探索性观察性研究]
Max Geraedts1, Christian Song Pham1
1Institut für Gesundheitsversorgungsforschung und Klinische Epidemiologie, Philipps-Universitat Marburg, Marburg, Germany.
概括
医生办公室的访问往往是可以避免的,特别是对于需要处方或例行检查的老年人. 这项研究分析了3266名患者的联系人,以了解访问的原因,并确定医疗保健提供中的潜在效率.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 初级医疗保健医学 一级医疗保健医学
- 门诊医疗保健管理的管理
背景情况:
- 准确的医生办公室访问数据对于平衡医疗保健供需至关重要.
- 2008年后的薪酬变化限制了仅使用计费数据准确估计门诊访问.
- 需要直接观察以了解访问频率,原因和可避免性.
研究的目的:
- 直接记录医生办公室访问的数量和原因.
- 估计这些患者接触的潜在可避免性.
- 分析不同实践类型,年龄组和性别的访问模式.
主要方法:
- 在11个全科医生 (GP) 和专家诊所对一周内所有患者访问的直接观察.
- 文件包括访问的原因,接触类型,患者年龄和性别.
- 用描述性分析和奇平方测试来分析频率和差异.
主要成果:
- 总共记录了3266个实践接触者 (57%为女性,43%为男性).
- 每个季度每位患者的平均访问量为全科医生2.9,专家1.9.
- 在59岁以上的患者中,50%的全科医生访问和51%的专家访问是为了处方补充或慢性疾病监测,这表明潜在的可避免性.
结论:
- 外推数据表明,每人每年有16.9次与医生办公室接触.
- 访问的很大一部分,特别是对于收集处方或定期专家检查的老年人来说,可能是可以避免的.
- 研究结果强调,需要制定战略,以优化门诊医疗的利用率,减少不必要的医生接触.
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