社会问题、初级医疗保健以及帮助与支持的途径:在个体层面解决健康不平等问题。第一部分:全科医生的视角。

Social problems, primary care and pathways to help and support: addressing health inequalities at the individual level. Part I: the GP perspective.

作者信息

Popay Jennie, Kowarzik Ute, Mallinson Sara, Mackian Sara, Barker Jacqui

机构信息

Institute for Health Research, Lancaster University, Alexandra Square, Lancaster LA1 4NT, UK.

出版信息

J Epidemiol Community Health. 2007 Nov;61(11):966-71. doi: 10.1136/jech.2007.061937.

Abstract

OBJECTIVES

This study aimed to describe social problems presented to general practitioners (GPs) in UK inner cities and GPs' responses; describe patients' help-seeking pathways; and consider how these pathways can be improved.

METHODS

The study involved a pilot survey and follow-up qualitative interviews with patients in two inner city areas in London and Salford in 2001-2. The pilot survey involved five practices in each locality. GPs completed questionnaires on 57 people presenting with social problems. A diversity sample of 12 patients were followed up for interview.

RESULTS

Study results are presented in two parts. This paper focuses on the GP survey results. People were presenting with a wide range of social problems, and multiple problems were also common. Problems with welfare benefits and housing were the most common, but GPs were most likely to refer to counselling services and to a lesser extent to generic advice services. Some GPs would have preferred to refer patients to more problem-specific services but did not believe these were available.

CONCLUSIONS

The study highlights the role GPs play in helping people deal with social problems but also identifies limitations in their response to these problems. It points to the need for more integrated pathways to help and advice for social problems. Primary care can make existing pathways more visible and accessible, and create new pathways through, for example, the new commissioning role and extending the scope of social prescribing.

摘要

目的

本研究旨在描述英国内城区全科医生(GP)所面临的社会问题及其应对措施;描述患者寻求帮助的途径;并探讨如何改进这些途径。

方法

该研究在2001 - 2002年对伦敦和索尔福德两个内城区的患者进行了试点调查及后续定性访谈。试点调查在每个地区涉及五个诊所。全科医生就57名存在社会问题的患者填写了问卷。对12名患者进行了多样化抽样随访访谈。

结果

研究结果分为两部分呈现。本文聚焦于全科医生的调查结果。人们面临着广泛的社会问题,多种问题也很常见。福利和住房问题最为普遍,但全科医生最常将患者转介至咨询服务,在较小程度上转介至一般性建议服务。一些全科医生本希望将患者转介至更具针对性的服务,但认为此类服务不存在。

结论

该研究凸显了全科医生在帮助人们应对社会问题方面所发挥的作用,但也指出了他们在应对这些问题时的局限性。这表明需要有更综合的途径来提供社会问题方面的帮助和建议。初级保健可以使现有途径更明显且更易获取,并通过例如新的委托职责和扩大社会处方范围来创建新途径。

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