Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California 94110, USA.
Ann Fam Med. 2012 Sep-Oct;10(5):396-400. doi: 10.1370/afm.1400.
PURPOSE Primary care faces the dilemma of excessive patient panel sizes in an environment of a primary care physician shortage. We aimed to estimate primary care panel sizes under different models of task delegation to nonphysician members of the primary care team. METHODS We used published estimates of the time it takes for a primary care physician to provide preventive, chronic, and acute care for a panel of 2,500 patients, and modeled how panel sizes would change if portions of preventive and chronic care services were delegated to nonphysician team members. RESULTS Using 3 assumptions about the degree of task delegation that could be achieved (77%, 60%, and 50% of preventive care, and 47%, 30%, and 25% of chronic care), we estimated that a primary care team could reasonably care for a panel of 1,947, 1,523, or 1,387 patients. CONCLUSIONS If portions of preventive and chronic care services are delegated to nonphysician team members, primary care practices can provide recommended preventive and chronic care with panel sizes that are achievable with the available primary care workforce.
在初级保健医生短缺的环境下,初级保健面临患者群体过大的困境。我们旨在估算在将初级保健团队中非医师成员的任务委托给不同模式下的初级保健群体规模。
我们使用发表的估算值,即初级保健医生为 2500 名患者提供预防、慢性和急性护理所需的时间,并对如果将部分预防和慢性护理服务委托给非医师团队成员,群体规模将如何变化进行建模。
根据可实现的任务委托程度的 3 种假设(77%、60%和 50%的预防护理,47%、30%和 25%的慢性护理),我们估计初级保健团队可以合理地照顾 1947、1523 或 1387 名患者。
如果将部分预防和慢性护理服务委托给非医师团队成员,初级保健实践可以在现有的初级保健劳动力可实现的群体规模下提供推荐的预防和慢性护理。