全科医生合作组织提供的非工作时间姑息治疗:可及性、内容及信息传递效果
Out-of-hours palliative care provided by GP co-operatives: availability, content and effect of transferred information.
作者信息
Schweitzer Bart P M, Blankenstein Nettie, Deliens Luc, van der Horst Henriette
机构信息
Department of General Practice, and EMGO+Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
出版信息
BMC Palliat Care. 2009 Nov 28;8:17. doi: 10.1186/1472-684X-8-17.
BACKGROUND
Out-of-hours GP care in England, Denmark and the Netherlands has been reorganised and is now provided by large scale GP co-operatives. Adequate transfer of information is necessary in order to assure continuity of care, which is of major importance in palliative care. We conducted a study to assess the availability, content and effect of information transferred to the GP co-operatives.
METHODS
Cross-sectional exploratory study of all palliative care phone calls during a period of one year to a GP co-operative.
RESULTS
The total number of phone calls about patients who needed palliative care was 0.75% of all calls to the GP co-operative. Information was transferred by GPs on 25.5% of palliative care patient calls, and on 12% of palliative care patient calls from residential care homes. For terminally ill patients the number of information transfers increased to 28.9%. When information was transferred, the content consisted mainly of clinical data. Information about the diagnosis and current problems was transferred in more than 90% of cases, information about the patient's wishes in 45% and information about the patient's psychosocial situation in 30.5% of cases.A home visit was made after 53% of the palliative care calls.When information was transferred, fewer patients were referred to a hospital.
CONCLUSION
GPs frequently fail to transfer information about their palliative care patients to the GP co-operatives. Locums working at the GP co-operative are thus required to provide palliative care in complex situations without receiving adequate informationGPs should be encouraged and trained to make this information available to the GP co-operatives.
背景
英国、丹麦和荷兰的非工作时间全科医生护理已进行了重组,现由大规模的全科医生合作社提供。为确保护理的连续性,充分的信息传递是必要的,这在姑息治疗中至关重要。我们开展了一项研究,以评估传递给全科医生合作社的信息的可用性、内容和效果。
方法
对一年内拨打给一个全科医生合作社的所有姑息治疗电话进行横断面探索性研究。
结果
关于需要姑息治疗患者的电话总数占拨打给全科医生合作社所有电话的0.75%。全科医生在25.5%的姑息治疗患者电话中传递了信息,在来自养老院的姑息治疗患者电话中这一比例为12%。对于晚期患者,信息传递的比例增至28.9%。当传递信息时,内容主要包括临床数据。超过90%的情况传递了关于诊断和当前问题的信息,45%的情况传递了关于患者意愿的信息,30.5%的情况传递了关于患者心理社会状况的信息。53%的姑息治疗电话后进行了家访。当传递信息时,转诊至医院的患者较少。
结论
全科医生常常未能将其姑息治疗患者的信息传递给全科医生合作社。因此,在全科医生合作社工作的临时代理医生需要在未获得充分信息的情况下在复杂情形中提供姑息治疗。应鼓励并培训全科医生向全科医生合作社提供此类信息。
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