基于多专业团队的初级保健系统中的GP周转率:来自瑞典的证据
Lina Maria Ellegård1,2, Anders Anell3, Gustav Kjellsson4,5
1Department of Economics, Lund University School of Economics and Management, Sweden.
瑞典的初级医疗保健有很高的全科医生 (GP) 流动,平均每年30%,主要是由于临时工作人员. 这种流动性虽然提供了灵活性,但阻碍了患者的护理连续性.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗服务管理 医疗服务管理
- 一般实践 劳动力研究 劳动力研究
背景情况:
- 一般医生 (GP) 的招聘和保留是初级保健中的重大挑战.
- 瑞典的模式包括多专业团队,有薪的全科医生和任务转移,影响劳动力动力.
- 雇佣和固定合同可能会增加GP的流动性和营业额.
研究的目的:
- 量化瑞典某个地区的初级保健实践流动率.
- 调查实践特征与GP营业额之间的关联.
- 了解临时与永久GP就业对营业额的影响.
主要方法:
- 分析了来自瑞典斯卡内 (Skåne) 的157家初级保健医院的观察性登记数据 (2010-2018).
- 计算每年实践周转率,包括永久和临时医生.
- 永久聘用全科医生和注册人员 (2019年) 的补充分析以及实践特征的回归分析.
主要成果:
- 年度实践营业额平均为30% (范围为20-40%),没有明显的时间趋势.
- 高周转率主要是由临时的全科医生 (GPs) 推动的.
- 在服务于社会贫困人口或面临高工作负载的实践中,营业额较高;在控制工作负载时,私人实践的营业额较低.
结论:
- 一个雇佣有薪的全科医生 (GPs) 的初级保健系统可以促进更大的全科医生流动性.
- 便利的GP流动性,虽然可能有利于劳动力的灵活性,但对患者护理的连续性提出了挑战.
- 在促进GP流动性的系统中,需要加强护理连续性的策略.
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