Olfson M, Marcus S C, Pincus H A
New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, NY 10032, USA.
Am J Psychiatry. 1999 Mar;156(3):451-7. doi: 10.1176/ajp.156.3.451.
The authors examine trends in the composition and duration of visits to psychiatrists in office-based psychiatric practice.
An analysis was performed of physician-reported data from the 1985 and 1995 National Ambulatory Medical Care Surveys focusing on visits to physicians specializing in psychiatry. Secular changes in visit characteristics were assessed, and mean visit durations were determined for selected sociodemographic and clinical groups.
In the decade between 1985 and 1995, visits in office-based psychiatry became shorter, less often included psychotherapy, and more often included a medication prescription. The proportion of visits that were 10 minutes or less in length increased. A shortening in visit duration was most evident for younger patients, privately insured patients, and patients who were not prescribed a psychotropic medication. In the 1995 survey, 6.8% of the psychiatric visits included patient contact with another health care professional.
Changing financial arrangements and new pharmacologic treatments may have contributed to these changes in practice style.
作者研究了门诊精神科诊疗中患者就诊构成及时长的变化趋势。
对1985年和1995年全国门诊医疗护理调查中医生报告的数据进行分析,重点关注精神科专科医生的诊疗情况。评估就诊特征的长期变化,并确定选定社会人口统计学和临床分组的平均就诊时长。
在1985年至1995年的十年间,门诊精神科诊疗的时长缩短,心理治疗的使用频率降低,药物处方的开具频率增加。就诊时长在10分钟及以内的比例上升。就诊时长缩短在年轻患者、私人保险患者以及未开具精神药物的患者中最为明显。在1995年的调查中,6.8%的精神科诊疗涉及患者与其他医疗保健专业人员的接触。
财务安排的变化和新的药物治疗可能促成了这些诊疗方式的改变。