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对来自英语背景和非英语背景患者的全科医疗问诊情况进行比较。

A comparison of general practice encounters with patients from English-speaking and non-English-speaking backgrounds.

作者信息

Knox Stephanie A, Britt Helena

机构信息

General Practice Statistics and Classification Unit, Acacia House, Westmead Hospital, PO Box 533, Wentworthville, NSW 2145, Australia.

出版信息

Med J Aust. 2002 Jul 15;177(2):98-101. doi: 10.5694/j.1326-5377.2002.tb04681.x.

Abstract

OBJECTIVE

To determine whether doctor-patient encounters in general practice with patients from a non-English-speaking background (NESB) differ from encounters with patients of English-speaking background (ESB) in terms of the type of practice where the encounters occur and the type of problems managed.

DESIGN AND SETTING

A national cross-sectional survey of GP-patient encounters from a sample of all active registered GPs in Australia.

PARTICIPANTS

A random sample of 1047 GPs recruited in the 12 months from April 1999 to March 2000, each providing details of 100 consecutive patient encounters.

MAIN OUTCOME MEASURES

GP demographics, practice characteristics, patient demographics (including whether the patient mainly spoke a language other than English at home), and problems managed at the encounter.

RESULTS

After adjusting for significant predictors, encounters with NESB patients were significantly more likely to occur at solo practices than practices of five or more GPs (odds ratio [OR], 2.15; 95% CI, 1.49-3.09), in metropolitan practices (OR, 6.34; 95% CI, 4.04-9.96), and with GPs who mostly consulted in a language other than English (OR, 5.44; 95% CI, 3.78-7.83). NESB encounters were relatively more likely to involve a respiratory problem (OR, 1.14; 95% CI, 1.04-1.26), endocrine/metabolic problem (OR, 1.41; 95% CI, 1.22-1.63) or digestive problem (OR, 1.14; 95% CI, 1.02-1.27), and relatively less likely to involve a psychological problem (OR, 0.73; 95% CI, 0.61-0.88) or social problem (OR, 0.67; 95% CI, 0.49-0.92).

CONCLUSION

Differences in morbidity management rates between encounters with NESB patients and ESB patients may reflect both differences in underlying prevalences of some disorders in the population of general practice patients, as well as different reasons among the two groups for attending general practice.

摘要

目的

确定在全科医疗中,与非英语背景(NESB)患者的医患诊疗过程,在诊疗发生的机构类型以及所处理问题的类型方面,是否与英语背景(ESB)患者的诊疗过程存在差异。

设计与背景

对澳大利亚所有在职注册全科医生样本中的医患诊疗情况进行全国性横断面调查。

参与者

在1999年4月至2000年3月的12个月内招募的1047名全科医生的随机样本,每人提供连续100次患者诊疗的详细信息。

主要观察指标

全科医生的人口统计学特征、诊疗机构特征、患者人口统计学特征(包括患者在家中主要使用的语言是否不是英语)以及诊疗时处理的问题。

结果

在对显著预测因素进行调整后,与NESB患者的诊疗相比,在单人执业机构而非五名或更多全科医生的机构中发生诊疗的可能性显著更高(优势比[OR],2.15;95%置信区间[CI],1.49 - 3.09),在大都市地区的机构中(OR,6.34;95% CI,4.04 - 9.96),以及与主要使用非英语进行诊疗的全科医生处(OR,5.44;95% CI,3.78 - 7.83)。与NESB患者的诊疗相对更有可能涉及呼吸系统问题(OR,1.14;95% CI,1.04 - 1.26)、内分泌/代谢问题(OR,1.41;95% CI,1.22 - 1.63)或消化系统问题(OR,1.14;95% CI,1.02 - 1.27),而相对不太可能涉及心理问题(OR,0.73;95% CI,0.61 - 0.88)或社会问题(OR,0.67;95% CI,0.49 - 0.92)。

结论

与NESB患者和ESB患者的诊疗过程中发病率管理率的差异,可能既反映了全科医疗患者群体中某些疾病潜在患病率的差异,也反映了两组患者就诊于全科医疗的不同原因。

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