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新加坡的初级保健至三级保健转诊的因素和决定因素:使用人工智能驱动的大型语言模型进行多中心分析
Sky Wei Chee Koh1,2, Jasper Yi Xuan Huang3, Joelle Lam1,4
1National University Polyclinics, National University Health System, Singapore.
PloS one
|February 5, 2026
概括
这项研究分析了100万次新加坡初级保健访问,发现每5次转诊中有1次. 大型语言模型确定了诸如视力模糊,转诊率差异和长时间等待等原因,需要注意优化医疗保健.
科学领域:
- 医疗保健管理的管理
- 公共卫生 公共卫生
- 医疗信息学 医疗信息学
背景情况:
- 新加坡的Healthier SG倡议需要优化医疗保健资源.
- 从初级到高等保健的转诊是资源管理的一个关键领域.
- 了解转诊模式和等待时间对于医疗保健效率至关重要.
研究的目的:
- 分析推原因,等待时间和影响新加坡初级至三级医疗保健的因素.
- 利用大型语言模型 (LLM) 来从临床笔记中分类转诊原因.
- 为了确定转诊率和患者结果的差异.
主要方法:
- 分析了来自新加坡7家初级保健诊所的1,063,646名患者访问 (2023年).
- 使用LLM克劳德3.5索内特来从笔记中分类转介原因.
- 采用了基平方测试和通用线性模型 (GLM) 来分析转介因子.
主要成果:
- 19.8%的访问导致转诊,眼科,整形外科和急诊作为顶级专业.
- 主要的转诊原因包括视力模糊,糖尿病视网膜病变查异常和产前护理.
- 推率因诊所,患者人口统计 (年龄,性别,种族) 和医生经验而异;平均等待时间为52.7天.
结论:
- 在新加坡的初级保健系统中,推率,模式和等待时间存在显著差异.
- 对初级保健医生的持续教育和支持至关重要.
- 需要量身定制的资源分配和进一步的研究,以确保及时和适当的转诊.
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