Durham J A, McLeod D K
Department of General Practice, Wellington School of Medicine.
N Z Med J. 1999 Jun 25;112(1090):233-6.
To record general practitioners use of diagnostic imaging facilities in areas with different levels of access.
A random sample of general practitioners from three different areas kept a prospective record for one month of all patients referred to diagnostic imaging facilities, the outcomes of these investigations and the total number of patients seen.
Referrals for diagnostic imaging services were significantly different between the localities (p = 0.014). The area with the least restrictions on access and the highest referral rate showed the greatest variation between doctors. There was a significant difference (p = 0.047) between the localities for patients who could not be referred because of restricted access and the cost of the services. The majority (68%) of patients who were unable to access these services were referred to the hospital for admission, for an outpatient appointment or to the accident and emergency department. There was little difference between the localities in either the presence or absence of pathology, or in the proportion of patients where the diagnosis was changed as a result of the diagnostic imaging investigation.
Improved access to diagnostic imaging services for patients of general practitioners would result in better patient management and prevent unnecessary hospital referrals.
记录全科医生在不同获取途径水平地区对诊断成像设施的使用情况。
从三个不同地区随机抽取全科医生样本,对所有转诊至诊断成像设施的患者进行为期一个月的前瞻性记录,记录这些检查的结果以及就诊患者总数。
各地区间诊断成像服务的转诊情况存在显著差异(p = 0.014)。获取途径限制最少且转诊率最高的地区,医生之间的差异最大。因获取途径受限和服务费用而无法转诊的患者在各地区之间存在显著差异(p = 0.047)。大多数(68%)无法获得这些服务的患者被转诊至医院住院、门诊预约或急诊部门。各地区在有无病理情况方面,或因诊断成像检查而改变诊断的患者比例方面差异不大。
改善全科医生患者对诊断成像服务的获取途径,将有助于更好地管理患者并防止不必要的医院转诊。