van Uden Caro J T, Nieman Fred H M, Voss Gemma B W E, Wesseling Geertjan, Winkens Ron A G, Crebolder Harry F J M
Department of Integrated Care, Research Institute Caphri, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.
BMC Health Serv Res. 2005 Mar 31;5(1):27. doi: 10.1186/1472-6963-5-27.
In recent years, Dutch general practitioner (GP) out-of-hours service has been reorganised into large-scale GP cooperatives. Until now little is known about GPs' experiences with working at these cooperatives for out-of-hours care. The purpose of this study is to gain insight into GPs' satisfaction with working at GP cooperatives for out-of-hours care in separated and integrated cooperatives.
A GP cooperative separate from the hospital Accident and Emergency (A&E) department, and a GP cooperative integrated within the A&E department of another hospital. Both cooperatives are situated in adjacent geographic regions in the South of The Netherlands. One hundred GPs were interviewed by telephone; fifty GPs working at the separated GP cooperative and fifty GPs from the integrated GP cooperative. Opinions on different aspects of GP cooperatives for out-of-hours care were measured, and regression analysis was performed to investigate if these could be related to GP satisfaction with out-of-hours care organisation.
GPs from the separated model were more satisfied with the organisation of out-of-hours care than GPs from the integrated model (70 vs. 60 on a scale score from 0 to 100; P = 0.020). Satisfaction about out-of-hours care organisation was related to opinions on workload, guarantee of gatekeeper function, and attitude towards out-of-hours care as being an essential part of general practice. Cooperation with medical specialists was much more appreciated at the integrated model (77 vs. 48; P < 0.001) versus the separated model.
GPs in this study appear to be generally satisfied with the organisation of GP cooperatives for out-of-hours care. Furthermore, GPs working at the separated cooperative seem to be more satisfied compared to GPs working at the integrated cooperative.
近年来,荷兰全科医生(GP)的非工作时间服务已重组为大规模的全科医生合作社。到目前为止,对于全科医生在这些提供非工作时间护理的合作社工作的体验知之甚少。本研究的目的是深入了解全科医生对在独立和综合合作社中提供非工作时间护理的全科医生合作社工作的满意度。
一个与医院急诊科(A&E)分开的全科医生合作社,以及一个整合在另一家医院急诊科内的全科医生合作社。这两个合作社都位于荷兰南部相邻的地理区域。通过电话采访了100名全科医生;50名在独立的全科医生合作社工作的全科医生和50名来自综合全科医生合作社的全科医生。测量了对提供非工作时间护理的全科医生合作社不同方面的意见,并进行了回归分析,以调查这些意见是否与全科医生对非工作时间护理组织的满意度相关。
与综合模式的全科医生相比,独立模式的全科医生对非工作时间护理的组织更满意(在0至100的量表评分上分别为70分和60分;P = 0.020)。对非工作时间护理组织的满意度与对工作量、守门人功能的保障以及将非工作时间护理视为全科医疗重要组成部分的态度的意见相关。与独立模式相比,综合模式下与医学专家的合作更受赞赏(分别为77分和48分;P < 0.001)。
本研究中的全科医生似乎总体上对提供非工作时间护理的全科医生合作社的组织感到满意。此外,与在综合合作社工作的全科医生相比,在独立合作社工作的全科医生似乎更满意。