O'Reilly D, Steele K, Merriman B, Gilliland A, Brown S
Health and Social Care Research Unit, Queen's University of Belfast, Northern Ireland.
Br J Gen Pract. 1998 Oct;48(435):1669-73.
Being struck off a general practitioner's list is a major event for patients and a subject for much media attention. However, it has not hitherto received much research attention.
To quantify the numbers of patients removed at doctors' request in Northern Ireland between 1987 and 1996. To describe the characteristics of those removed and to determine if the rate of removal has increased.
This is a descriptive epidemiological study involving a secondary data analysis of records held by the Central Services Agency.
Six thousand five hundred and seventy-eight new patients were removed at general practitioner (GP) request between 1987 and 1996. This equated to 3920 removal decisions, a rate of 2.43 per 10,000 person-years. The very young and young adults had the highest rates of removal; most of the young being removed as part of a family. Ten point six per cent of removed patients had a repeat removal, and 16.3% of first removal decisions required an assignment to another practice. Family removals have decreased and individual removals have increased over the 10 years. Disadvantaged and densely populated areas with high population turnover were associated with higher rates of removal, though heterogeneity is evident between general practitioners serving similar areas. Compared to the period 1987 to 1991, removal rates for the years 1992 to 1993 were reduced by 20.0% (95% confidence interval (CI) for rate ratio (RR) 0.73-0.87), and those for the years 1994 to 1996 increased by 8% (95% CI = 1.01-1.16). The greatest increase was in the over-75 years age group (standardized RR = 1.60; 95% CI = 1.57-1.62).
Removals are relatively rare events for both patients and practices, though they have been increasing in recent years. Further research is needed to understand the processes that culminate in a removal.
被从全科医生的名单中除名对患者来说是一件大事，也是媒体大量关注的话题。然而，迄今为止它并未受到太多研究关注。
量化1987年至1996年间北爱尔兰因医生要求而被除名的患者数量。描述被除名者的特征，并确定除名率是否有所上升。
这是一项描述性流行病学研究，涉及对中央服务局保存记录的二次数据分析。
1987年至1996年间，有6578名新患者因全科医生的要求被除名。这相当于3920项除名决定，即每10000人年2.43的比率。非常年幼和年轻的成年人除名率最高；大多数年轻人是作为家庭的一部分被除名的。10.6%的被除名患者被再次除名，16.3%的首次除名决定需要分配到另一家诊所。在这10年中，家庭除名减少，个人除名增加。人口流动率高的贫困和人口密集地区除名率较高，尽管在服务于类似地区的全科医生之间存在明显的异质性。与1987年至1991年期间相比，1992年至1993年的除名率降低了20.0%（比率比（RR）的95%置信区间（CI）为0.73 - 0.87），1994年至1996年的除名率增加了8%（95%CI = 1.01 - 1.16）。增幅最大的是75岁以上年龄组（标准化RR = 1.60；95%CI = 1.57 - 1.62）。
除名对患者和诊所来说都是相对罕见的事件，尽管近年来有所增加。需要进一步研究以了解导致除名的过程。
