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澳大利亚患者与全科医生的关联——谁是,谁不是,这有关系吗?

Patient affiliation with GPs in Australia--who is and who is not and does it matter?

机构信息

Australian Primary Health Care Research Institute, The Australian National University, Canberra, ACT 0200, Australia.

出版信息

Health Policy. 2011 Nov;103(1):16-23. doi: 10.1016/j.healthpol.2010.09.002. Epub 2010 Oct 2.

Abstract

UNLABELLED

AIMS AND RATIONALE: Recent government reports have proposed voluntary enrolment with general practitioners for certain groups of patients to enhance their continuity of care. We examine which groups of patients are presently "de facto" affiliated with GPs, and whether affiliated patients are more likely to receive advice from their GPs on primary preventative matters such as weight, exercise and smoking.

METHODS

A nationally representative cross sectional survey of Australian residents aged 18 years or over was conducted via telephone in 2008. Data from 1146 participants were analysed in both tabular forms and with logistic regression.

FINDINGS

Most Australian adults are affiliated, de facto, with an individual GP or a GP practice (11% often go to different GPs). Factors associated with affiliation were patient age, education, satisfaction with their GP and urban or rural location. Patients with poor or fair self assessed health are relatively unlikely to be affiliated with a GP. Weak support was found for the hypothesis that affiliated patients were more likely to receive primary preventative advice on weight and diet and no support found in relation to exercise, smoking or alcohol consumption.

BENEFITS TO THE COMMUNITY

The study suggests policy on voluntary patient enrolment should focus on providing continuity of care to those with poor health. If further studies confirm affiliation does not enhance preventive health advice, further policy interventions may be appropriate.

摘要

目的和理由

最近的政府报告提议让某些患者群体自愿选择家庭医生,以增强他们的连续性护理。我们调查了哪些患者群体目前实际上与家庭医生有关联,以及关联患者是否更有可能从他们的家庭医生那里获得有关体重、运动和吸烟等初级预防事项的建议。

方法

我们在 2008 年通过电话对澳大利亚 18 岁及以上的居民进行了一项全国代表性的横断面调查。对 1146 名参与者的数据进行了表格形式和逻辑回归分析。

发现

大多数澳大利亚成年人实际上与个体家庭医生或家庭医生诊所有关联(11%的人经常去不同的家庭医生处就诊)。与关联相关的因素包括患者年龄、教育程度、对家庭医生的满意度以及居住地是城市还是农村。自我评估健康状况较差或一般的患者相对不太可能与家庭医生有关联。关联患者更有可能获得关于体重和饮食的初级预防建议的假设得到了微弱支持,但在运动、吸烟或饮酒方面没有得到支持。

对社区的好处

该研究表明,关于患者自愿登记的政策应侧重于为健康状况不佳的患者提供连续性护理。如果进一步的研究证实关联并没有增强预防保健建议,那么可能需要进一步的政策干预。

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