Beale Norman, Hollinghurst Sandra, Taylor Gordon, Gwynne Mark, Peart Carole, Straker-Cook Dawn
Northlands R&D General Practice, Calne, Wiltshire, UK.
Fam Pract. 2005 Jun;22(3):317-22. doi: 10.1093/fampra/cmi014. Epub 2005 Apr 1.
It is difficult to measure and compare workload in UK general practice. A GP/health economist team recently proposed a means of calculating the unit cost of a GP consulting. It is therefore now possible to extrapolate to the costs of other clinical tasks in a practice and then to compare the workloads of caring for different patients and compare between practices.
The study aims were: (i) to estimate the relative costs of daily clinical activities within a practice (implying workload); and (ii) to compare the costs of caring for different types of patients categorized by gender, by age, and by socio-economic status as marked by the Council Tax Valuation Band (CTVB) of home address.
The study design was a cross-sectional cost comparison of all clinical activity aggregated, by patient, over one year in an English semi-rural general practice. The subjects were 3339 practice patients, randomly selected. The main outcome measures were costs per clinical domain and overall costs per patient per year; both then compared by gender, age group and by CTVB.
CTVB is as significant a predictor of patient care cost (workload) as is patient gender and age (both already known).
It is now possible to estimate the cost of care of different patients in such a way that NHS planning and especially resource allocation to practices could be improved.
在英国的全科医疗中,工作量难以衡量和比较。一个全科医生/健康经济学家团队最近提出了一种计算全科医生诊疗单位成本的方法。因此,现在可以推断出诊所中其他临床任务的成本,进而比较照顾不同患者的工作量以及不同诊所之间的工作量。
本研究的目的是:(i)估计诊所内日常临床活动的相对成本(意味着工作量);(ii)比较照顾不同类型患者的成本,这些患者按性别、年龄以及根据家庭住址的市政税估值等级(CTVB)划分的社会经济地位进行分类。
本研究设计为对英国一个半乡村全科诊所一年内按患者汇总的所有临床活动进行横断面成本比较。研究对象为随机选取的3339名诊所患者。主要结局指标为每个临床领域的成本以及每位患者每年的总成本;然后按性别、年龄组和CTVB进行比较。
CTVB与患者性别和年龄(两者均已为人所知)一样,是患者护理成本(工作量)的重要预测指标。
现在有可能以这样一种方式估计不同患者的护理成本,从而改善国民医疗服务体系(NHS)的规划,尤其是对诊所的资源分配。