Grytten Jostein, Skau Irene, Sørensen Rune
Seksjon for samfunnsodontologi, Universitetet i Oslo, Postboks 1052 Blindern, 0316 Oslo.
Tidsskr Nor Laegeforen. 2005 May 19;125(10):1357-60.
The article describes changes in the size of practices after the introduction of the new Norwegian list patient system for general practitioners (GPs) and how length of patient lists, number of consultations, working hours and waiting time for an appointment vary according to the number of physicians in the practice.
The data were collected by a comprehensive questionnaire survey among general practitioners in the autumn of 2002. A total of 2306 physicians took part (response rate: 70%).
Before the list patient system was introduced, 18% of GPs worked in solo practices. With the new system in place, the proportion went down to 15%. About 60% of GPs worked in practices with 2-4 GPs. Out of young GPs in solo practices, 78% wished to work in practices with several colleagues, while 26% of GPs in practices with more than six physicians wished to reduce the size of the practice. The number of patients on the list and the number of curative working hours per GP decreased with increasing practice size. The number of consultations per hour did not vary with the number of GPs in the practice. Waiting time for an appointment for non-emergency treatment increased with increasing practice size.
A lower service production per physician in large practices may partly be an effect of a relatively high proportion of women wanting to work fewer hours than their male colleagues. Irrespective of gender, group practices also attract GPs who want slightly reduced working hours.
本文描述了挪威为全科医生引入新的列表患者系统后诊所规模的变化，以及患者列表长度、会诊次数、工作时间和预约等待时间如何根据诊所医生数量而有所不同。
2002年秋季通过对全科医生进行全面问卷调查收集数据。共有2306名医生参与（回复率：70%）。
在引入列表患者系统之前，18%的全科医生独自执业。新系统实施后，这一比例降至15%。约60%的全科医生在有2至4名全科医生的诊所工作。在独自执业的年轻全科医生中，78%希望在有多名同事的诊所工作，而在有六名以上医生的诊所中，26%的全科医生希望缩小诊所规模。随着诊所规模的增加，每个全科医生的患者列表数量和治愈性工作时间减少。每小时的会诊次数并不随诊所全科医生数量的变化而变化。非紧急治疗的预约等待时间随着诊所规模的增加而增加。
大型诊所中每位医生的服务产出较低，部分原因可能是女性希望工作时间比男性同事少的比例相对较高。无论性别如何，团队执业也吸引了那些希望稍微减少工作时间的全科医生。
