人口统计学和发病率因素对患者自我报告就诊频率的影响：澳大利亚全科医疗患者的横断面研究
The contribution of demographic and morbidity factors to self-reported visit frequency of patients: a cross-sectional study of general practice patients in Australia.
作者信息
Knox Stephanie A, Britt Helena
机构信息
AIHW General Practice Statistics and Classification Unit, Family Medicine Research Centre, University of Sydney, Sydney, Australia.
出版信息
BMC Fam Pract. 2004 Aug 20;5:17. doi: 10.1186/1471-2296-5-17.
BACKGROUND
Understanding the factors that affect patients' utilisation of health services is important for health service provision and effective patient management. This study aimed to investigate the specific morbidity and demographic factors related to the frequency with which general practice patients visit a general practitioner/family physician (GP) in Australia.
METHODS
A sub-study was undertaken as part of an ongoing national study of general practice activity in Australia. A cluster sample of 10,755 general practice patients were surveyed through a random sample of 379 general practitioners. The patient reported the number of times he/she had visited a general practitioner in the previous twelve months. The GP recorded all the patient's major health problems, including those managed at the current consultation.
RESULTS
Patients reported an average of 8.8 visits to a general practitioner per year. After adjusting for other patient demographics and number of health problems, concession health care card holders made on average 2.6 more visits per year to a general practitioner than did non-card holders (p <.001). After adjustment, patients from remote/very remote locations made 2.3 fewer visits per year than patients from locations where services were highly accessible (p <.001). After adjustment for patient demographics, patients with diagnosed anxiety made on average 2.7 more visits per year (p = 0.003), those with diagnosed depression 2.2 more visits than average (p <.0001), and those with back problems 2.4 more visits (p = 0.009) than patients without the respective disorders.
CONCLUSIONS
Anxiety, back pain and depression are associated with greater patient demand for general practice services than other health problems. The effect of sociodemographic factors on patient utilisation of general practice services is complex. Equity of access to general practice services remains an issue for patients from remote areas, while concession health care card holders are attending general practice more frequently than other patients relative to their number of health problems.
背景
了解影响患者利用卫生服务的因素对于卫生服务提供和有效的患者管理至关重要。本研究旨在调查与澳大利亚全科医疗患者拜访全科医生/家庭医生（GP）的频率相关的特定发病率和人口统计学因素。
方法
作为澳大利亚正在进行的一项关于全科医疗活动的全国性研究的一部分，开展了一项子研究。通过对379名全科医生进行随机抽样，对10755名全科医疗患者进行了整群抽样调查。患者报告了其在过去十二个月内拜访全科医生的次数。全科医生记录了患者所有的主要健康问题，包括在本次会诊中处理的问题。
结果
患者报告平均每年拜访全科医生8.8次。在对其他患者人口统计学因素和健康问题数量进行调整后，持有优惠医疗保健卡的患者每年拜访全科医生的次数比未持卡者平均多2.6次（p <.001）。调整后，来自偏远/非常偏远地区的患者每年拜访次数比服务极易获取地区的患者少2.3次（p <.001）。在对患者人口统计学因素进行调整后，被诊断患有焦虑症的患者每年拜访次数平均多2.7次（p = 0.003），被诊断患有抑郁症的患者比平均次数多2.2次（p <.0001），患有背部问题的患者比没有相应疾病的患者多2.4次（p = 0.009）。
结论
与其他健康问题相比，焦虑症、背痛和抑郁症与患者对全科医疗服务的更高需求相关。社会人口统计学因素对患者利用全科医疗服务的影响较为复杂。对于偏远地区的患者来说，获得全科医疗服务的公平性仍然是一个问题，而持有优惠医疗保健卡的患者相对于其健康问题数量而言，比其他患者更频繁地就诊于全科医疗。
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