Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia.
Med J Aust. 2010 Jan 4;192(1):20-3. doi: 10.5694/j.1326-5377.2010.tb03395.x.
To assess the extent to which general practitioners in Australia are engaged in identifying age-related hearing loss and facilitating its management.
DESIGN, SETTING AND PARTICIPANTS: Cross-sectional analysis of data collected between 1998 and 2000 from the Blue Mountains Hearing Study (BMHS), a representative population-based cohort of people aged >or= 50 years in two postcode areas west of Sydney. Also analysed were data collected between 2003 and 2008 from random samples of Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) study, a national continuous cross-sectional survey of GP activity.
Rate of facilitating management and identification of hearing loss in older patients; content of GP-patient encounters with hearing-impaired people; characteristics of participants seeking help from their GP.
Of older people in the BMHS with measured (objective) bilateral hearing loss, about a third reported seeking help from their GP. BEACH survey data showed that only about 3 per 1,000 GP consultations with patients aged >or= 50 years involved management of age-related hearing loss. For every 100 age-related hearing problems managed, GPs undertook 12 procedural treatments, provided 20 referrals to specialists, and made 29 referrals to allied health professionals.
In their routine consultations with patients, GPs have opportunities to identify hearing loss and appropriately refer patients to specialists or allied health professionals. Although GPs are responding to patient presentations for hearing loss, referring around 50% of cases, there appear to be relatively few cases in which hearing loss is identified opportunistically. Levels of identification and management of hearing loss by GPs in Australia are relatively low.
评估澳大利亚全科医生在识别与年龄相关的听力损失并促进其管理方面的参与程度。
设计、地点和参与者:对 1998 年至 2000 年期间在悉尼西部两个邮政编码区域进行的蓝山听力研究(BMHS)的横断面分析,这是一项针对>或=50 岁人群的代表性基于人群的队列研究。还分析了 2003 年至 2008 年期间参加全国连续横断面调查 GP 活动的澳大利亚全科医生(GP)随机样本的 BEACH 研究收集的数据。
促进老年患者听力损失管理和识别的比率;GP 与听力受损患者的医患接触内容;向 GP 寻求帮助的参与者的特征。
在 BMHS 中,有测量(客观)双侧听力损失的老年人中,约三分之一的人报告向 GP 寻求帮助。BEACH 调查数据显示,每 1000 次与年龄>或=50 岁患者的 GP 咨询中,只有约 3 次涉及与年龄相关的听力损失管理。每处理 100 个与年龄相关的听力问题,GP 进行 12 次程序治疗,提供 20 次转介给专科医生,并进行 29 次转介给联合健康专业人员。
在与患者的常规咨询中,GP 有机会识别听力损失并适当将患者转介给专科医生或联合健康专业人员。尽管 GP 对听力损失的患者就诊做出了回应,转介了约 50%的病例,但似乎只有相对较少的病例是偶然发现听力损失的。澳大利亚 GP 识别和管理听力损失的水平相对较低。