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研究常规做法及其患者与其他做法的比较——特伦特地区的横断面调查。

A comparison of research general practices and their patients with other practices--a cross-sectional survey in Trent.

作者信息

Hammersley Vicky, Hippisley-Cox Julia, Wilson Andrew, Pringle Mike

机构信息

Division of General Practice, University of Nottingham.

出版信息

Br J Gen Pract. 2002 Jun;52(479):463-8.

Abstract

BACKGROUND

When interpreting results of studies undertaken by research networks we need to know how representative volunteer practices and their registered patients are of the total population of practices and patients in their locality.

AIM

To compare the following in research and non-research general practices in one region: practice and population demography, morbidity and mortality, selected performance indicators, and health outcomes.

DESIGN OF STUDY

Cross-sectional survey.

SETTING

Sixty-six Trent Focus Collaborative Research Network general practices and 749 other general practices in Trent, United Kingdom.

METHOD

Practice characteristics and GP contract data were obtained from the NHS Executive, Quarry House, Leeds. The Trent Regional NHS Hospital Admission Database was searched to identify all relevant admissions to hospital from all practices between 1 April 1993 and 31 March 1997. Ward-linked data on cancer were obtained from the Trent Cancer Registry.

RESULTS

Of the 815 general practices in Trent Region in the study period, 66 (8%) were in the Trent Focus network. They were more likely to be involved in training GPs and to have a female partner. They tended to be larger, with fewer single-handed doctors and younger GPs. Network practices prescribed a higher proportion of generics (median % prescribed/practice = 70%, versus 51%, Mann-Whitney U = 1615, P<0.0001). There were no clinically important differences between hospital admission rates between the two groups or waiting times for surgical procedures. There was no difference in the incidence of cancer and standardised mortality ratios related to the electoral wards of the GP surgery.

CONCLUSION

Although there were differences in practice structure and some aspects of performance, we found no important differences in the demography of registered patients, nor in morbidity, mortality, or access to or use of secondary care.

摘要

背景

在解读研究网络开展的研究结果时,我们需要了解志愿性医疗机构及其注册患者在当地所有医疗机构及患者总体中具有多大的代表性。

目的

比较某一地区参与研究的全科医疗与非研究性全科医疗在以下方面的情况:医疗机构及人口统计学特征、发病率和死亡率、选定的绩效指标以及健康结局。

研究设计

横断面调查。

研究地点

英国特伦特地区的66家特伦特重点协作研究网络全科医疗诊所及749家其他全科医疗诊所。

方法

从位于利兹市采石场大厦的国民保健服务执行机构获取医疗机构特征及全科医生合同数据。检索特伦特地区国民保健服务医院入院数据库,以确定1993年4月1日至1997年3月31日期间所有诊所的所有相关住院情况。从特伦特癌症登记处获取与病房相关的癌症数据。

结果

在研究期间,特伦特地区的815家全科医疗诊所中,有66家(8%)属于特伦特重点网络。它们更有可能参与全科医生培训且有女性合伙人。它们往往规模更大,单干医生较少,全科医生更年轻。网络诊所开具的非专利药品比例更高(每家诊所开具的中位数比例 = 70%,而其他诊所为51%,曼-惠特尼U检验 = 1615,P<0.0001)。两组之间的住院率或手术等待时间在临床上无重要差异。与全科医疗诊所选区病房相关的癌症发病率和标准化死亡率无差异。

结论

尽管在医疗机构结构和某些绩效方面存在差异,但我们发现注册患者的人口统计学特征、发病率、死亡率以及二级医疗服务的可及性或使用情况方面均无重要差异。

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