反馈对改善全科医疗中检查医嘱开出效果的随机对照试验。

Randomised controlled trial of the effectiveness of feedback in improving test ordering in general practice.

作者信息

Baker Richard, Falconer Smith James, Lambert Paul C

机构信息

Clinical Governance Research and Development Unit, Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, UK.

出版信息

Scand J Prim Health Care. 2003 Dec;21(4):219-23. doi: 10.1080/02813430310002995.

OBJECTIVE

To assess the effectiveness of feedback on the number of pathology tests ordered by general practices.

DESIGN

Randomised controlled trial.

SETTING

General practices in two primary care groups in Leicestershire, UK.

SUBJECTS

58 general practitioners in 17 practices received guidelines then feedback at 3-month intervals for 1 year about the numbers of thyroid function, rheumatoid factor tests and urine cultures they ordered, and 38 general practitioners in 16 practices received guidelines then feedback about lipid and plasma viscosity tests.

MAIN OUTCOME MEASURES

Numbers of tests requested per thousand patients registered with each practice. RESULTS; There were no changes in the numbers of tests per thousand requested in either of the study groups for any of the tests.

CONCLUSIONS

Feedback did not have an influence on test ordering by general practitioners in this study. More intensive strategies may be required to change the use of laboratory tests.

目的

评估关于全科医疗中所开具病理检查数量的反馈的有效性。

设计

随机对照试验。

地点

英国莱斯特郡两个初级保健组中的全科医疗。

研究对象

17家诊所的58名全科医生收到了指南，然后在1年的时间里每隔3个月收到关于他们所开具的甲状腺功能、类风湿因子检测和尿培养数量的反馈，16家诊所的38名全科医生收到了指南，然后收到关于血脂和血浆粘度检测的反馈。

主要观察指标

每家诊所每千名注册患者所要求的检查数量。

结果

在任何一项检测中，两个研究组每千名患者所要求的检测数量均未发生变化。

结论

在本研究中，反馈并未对全科医生的检查开具产生影响。可能需要更强化的策略来改变实验室检查的使用情况。