Brown Judith Belle, Sangster L Michelle, Ostbye Truls, Barnsley Janet M, Mathews Maria, Ogilvie Gina
Centre for Studies in Family Medicine, Department of Family Medicine, The University of Western Ontario, London, Ontario, Canada.
Fam Pract. 2002 Apr;19(2):202-6. doi: 10.1093/fampra/19.2.202.
For over two decades, there has been controversy over the role and impact of walk-in clinics on primary health care. This study evaluates the providers' perspective on this topic.
The purpose of this qualitative study was to explore the perceptions and experiences of family physicians, emergency physicians and walk-in clinic physicians regarding the impact of walk-in clinics on Ontario's health care system.
The qualitative method of focus groups was used in this study. There were nine focus groups, each consisting of 4-9 participants, with a total of 63 physicians. The different practitioners (family physicians, emergency physicians, walk-in clinic physicians) attended separate focus groups. The focus groups explored the physicians' perceptions and experiences regarding the role and impact of walk-in clinics on Ontario's health care system. The focus groups were audio-taped and transcribed verbatim. The qualitative data analysis program NUD*IST was used to organize the data during the sequential thematic analysis.
Factors contributing to the growth and evolution of walk-in clinics in Ontario were identified. These included a perceived increase in patients' expectations for convenient health care and a perceived decrease in the availability of family physicians. These factors created a gap in primary care which was filled by walk-in clinics.
Participants' recommendations for narrowing this gap included an increase in both physician and patient accountability and changes to the current structure of primary health care delivery. These recommendations would either integrate walk-in clinics into the health care system or result in their elimination.
二十多年来,随诊诊所对初级卫生保健的作用和影响一直存在争议。本研究评估了提供者对这一话题的看法。
这项定性研究的目的是探讨家庭医生、急诊医生和随诊诊所医生对随诊诊所在安大略省卫生保健系统中所产生影响的看法和经历。
本研究采用焦点小组的定性方法。共有九个焦点小组,每个小组由4至9名参与者组成,总共63名医生。不同类型的从业者(家庭医生、急诊医生、随诊诊所医生)参加各自的焦点小组。这些焦点小组探讨了医生对随诊诊所在安大略省卫生保健系统中的作用和影响的看法和经历。焦点小组进行了录音,并逐字转录。在顺序主题分析过程中,使用定性数据分析程序NUD*IST来组织数据。
确定了促使安大略省随诊诊所发展演变的因素。这些因素包括患者对便捷医疗保健的期望明显增加,以及家庭医生的可获得性明显下降。这些因素造成了初级保健方面的缺口,随诊诊所填补了这一缺口。
参与者提出的缩小这一缺口的建议包括提高医生和患者的责任感,以及改变当前初级卫生保健服务的结构。这些建议要么将随诊诊所纳入卫生保健系统,要么导致其被淘汰。