University of Kentucky, Lexington, Kentucky40536-0284, USA.
Qual Health Res. 2012 Dec;22(12):1599-611. doi: 10.1177/1049732312458183. Epub 2012 Aug 27.
The prevalence of multiple health conditions, or multiple morbidity (MM), is increasing. Providing medical care for adults with MM presents challenges, including balancing disease management with prevention. We conducted in-depth semistructured interviews with 12 primary care physicians to explore their perspectives on prevention counseling among patients with MM. Participants described the complex relationship between disease management and prevention, highlighted the importance of patient motivation, and discussed various strategies to promote receptivity to prevention recommendations. The perceived potential benefits of prevention recommendations encouraged physicians to persist with such counseling, despite challenges presented by visit time constraints, reimbursement procedures, and concerns over futility. Physicians recommended the development of alternate care delivery and reimbursement models to overcome challenges of the existing health care system and to meet the prevention needs of patients with MM. We explore the implications of these findings for maximizing the health and quality of life of adults with MM.
多种健康状况（MM）的患病率正在上升。为患有 MM 的成年人提供医疗服务带来了挑战，包括平衡疾病管理与预防。我们对 12 名初级保健医生进行了深入的半结构化访谈，以探讨他们对 MM 患者预防咨询的看法。参与者描述了疾病管理和预防之间的复杂关系，强调了患者动机的重要性，并讨论了促进接受预防建议的各种策略。预防建议的潜在益处使医生们鼓励坚持这种咨询，尽管就诊时间限制、报销程序和对无效性的担忧带来了挑战。医生们建议制定替代的医疗服务提供和报销模式，以克服现有医疗体系的挑战，并满足 MM 患者的预防需求。我们探讨了这些发现对最大限度地提高 MM 成年患者的健康和生活质量的意义。
