Varley J, Fitzsimons M, Delanty N, Collins C, Boland M, Normand C
Epilepsy Programme, Beaumont Hospital, Dublin 9.
Ir Med J. 2009 Jun;102(6):173-6.
Epilepsy care in Ireland is shared between primary, secondary and tertiary care services with the General Practitioner (GP) managing the process. Barriers to effective epilepsy care in Irish general practice remain undocumented although sub-optimal and fragmented services are frequently anecdotally reported. This survey of Irish GPs reports on such barriers to epilepsy care and on the Information & Communication Technology (ICT) issues potentially relevant to the use of an epilepsy specific Electronic Patient Record (EPR). The response rate was 247/700 (35.3%). Respondents supported the concept of shared care for epilepsy 237 (96%) however they were very dissatisfied with existing neurology services, including pathways of referral 207 (84%) and access to specialist neurology advice and investigations 232 (94%). They reported that neurology services and investigations may be accessed more expeditiously by patients with private health insurance than those without 178 (72%). Consequently many patients are referred to the emergency department for assessment and treatment 180 (73%). A deficit in epilepsy care expertise among GPs was acknowledged 86 (35%). While computerisation of GP practices appears widespread 230 (93%), just over half the respondents utilise available electronic functionalities specific to chronic disease management. GP specific electronic systems infrequently link or communicate with external electronic sources 133 (54%). While the current pathways of care for epilepsy in Ireland appear fragmented and inadequate, further investigations to determine the quality and cost effectiveness of the current service are required.
爱尔兰的癫痫护理由初级、二级和三级护理服务共同承担，由全科医生（GP）管理这一过程。尽管经常有传闻称爱尔兰全科医疗中癫痫护理服务欠佳且零散，但有效癫痫护理的障碍仍未得到记录。这项针对爱尔兰全科医生的调查汇报了癫痫护理的此类障碍以及与使用特定癫痫电子病历（EPR）可能相关的信息与通信技术（ICT）问题。回复率为247/700（35.3%）。受访者支持癫痫共享护理的理念，有237人（96%）表示支持，然而他们对现有神经科服务非常不满，包括转诊途径，有207人（84%）持此看法，以及获取专科神经科建议和检查，有232人（94%）不满。他们报告称，拥有私人医疗保险的患者比没有的患者能更快获得神经科服务和检查，有178人（72%）这样认为。因此，许多患者被转诊至急诊科进行评估和治疗，有180人（73%）。86人（35%）承认全科医生在癫痫护理专业知识方面存在不足。虽然全科医疗的计算机化似乎很普遍，有230人（93%）表示如此，但只有略超过一半的受访者使用了慢性病管理特有的可用电子功能。全科医生专用电子系统很少与外部电子源链接或通信，有133人（54%）。虽然爱尔兰目前的癫痫护理途径似乎零散且不足，但需要进一步调查以确定当前服务的质量和成本效益。
