Abt Bio-Pharma Solutions, Inc., Lexington, MA, USA.
J Eval Clin Pract. 2012 Aug;18(4):793-8. doi: 10.1111/j.1365-2753.2011.01678.x. Epub 2011 May 3.
The office time required for primary care physicians (PCPs) to diagnose, treat and manage fibromyalgia (FM) patients can be extensive. The study objective was to determine if PCPs can positively impact practice economics by requiring fewer patient visits and less office time, while still achieving an acceptable quality of life, as reported by the physician.
Survey of PCPs who diagnose, manage and treat FM patients.
Surveys were administered to US private practice PCPs, obtaining information on the number of office visits, and time spent with FM patients. PCPs were allotted into two groups: FM-efficient (FME; n = 40) and FM usual care (FMUC; n = 54), based on their reported ability to achieve an acceptable quality of life for ≥50% of their FM patients in less than four office visits post FM diagnosis. An economic model estimated the monetary value of each PCP cohorts' time spent with a newly diagnosed FM patient over a 2-year timeframe.
Significant office time cost differences across 2 years exist between FME PCPs and FMUC PCPs ($840 vs. $1117, P < 0.05). FME PCPs had a significantly lower cost of scheduled time to confirm diagnosis ($243 vs. $339, P < 0.05) and time to find right treatment ($264 vs. $365, P < 0.05) than FMUC PCPs. Both groups incurred costs related to excess visit time, but it was less for FME PCPs ($119, 29 minutes) than FMUC PCPs ($182, 44 minutes, P < 0.01), driven by quicker diagnosis confirmation (P < 0.01) and treatment initiation (P < 0.01).
Research suggests that efficient FM care delivery during diagnosis and treatment can be associated with improved practice economics.
初级保健医生（PCP）诊断、治疗和管理纤维肌痛（FM）患者所需的办公时间可能很长。研究目的是确定 PCP 是否可以通过减少患者就诊次数和办公时间，同时仍能达到医生报告的可接受的生活质量，从而对实践经济学产生积极影响。
对诊断、管理和治疗 FM 患者的 PCP 进行调查。
向美国私人执业的 PCP 发放调查问卷，获取有关就诊次数和与 FM 患者相处时间的信息。根据他们报告的在 FM 诊断后不到 4 次就诊即可为≥50%的 FM 患者实现可接受的生活质量的能力，将 PCP 分为两组：FM 高效（FME；n = 40）和 FM 常规护理（FMUC；n = 54）。在 2 年的时间框架内，经济模型估计每位新诊断的 FM 患者每位 PCP 花费的时间的货币价值。
FME PCP 和 FMUC PCP 在 2 年内的门诊时间成本存在显著差异（840 美元对 1117 美元，P < 0.05）。FME PCP 确诊诊断的预约时间成本（243 美元对 339 美元，P < 0.05）和寻找正确治疗方法的时间成本（264 美元对 365 美元，P < 0.05）明显低于 FMUC PCP。两组都产生了与额外就诊时间相关的成本，但 FME PCP 的成本较低（119 美元，29 分钟），而 FMUC PCP 的成本较高（182 美元，44 分钟，P < 0.01），原因是确诊时间更快（P < 0.01）和治疗开始时间（P < 0.01）。
研究表明，在诊断和治疗期间进行高效的 FM 护理可以改善实践经济学。
