Ashby J, Buxton M, Gravelle H
Health Economics Research Group, Brunel University, Uxbridge, Middlesex, United Kingdom.
J Epidemiol Community Health. 1990 Mar;44(1):36-8. doi: 10.1136/jech.44.1.36.
The aim of the study was to consider possible changes in the clinical activities of general practitioners whose patients are registered in a breast cancer screening programme.
The study was a survey based on completion of forms recording breast consultations carried out by participating general practitioners during a four week period.
One of three intervention centres and one of three comparison centres in the national trial of early detection of breast cancer was selected. The intervention centre was in Guildford; the comparison centre in Stoke on Trent.
The participants were general practitioners in the selected centres. In Guildford, 64 of 99 general practitioners approached took part (65%); in Stoke on Trent, 81 of 177 took part (46%). The proportion of male and female participants in the two centres was similar. Doctors in Stoke on Trent were older and worked in smaller practices than in Guildford.
A comparison of workloads showed that in the screening centre there was less demand for doctor consultations from those in the screened age group, but those excluded from screening made more use of the general practitioners' services. A difference in referral practice was also apparent, with doctors in the screening centre referring more frequently for specialist advice.
The evidence suggests that no significant change in the overall use of general practice resources can be expected with the introduction of national screening, but there may be greater pressure on assessment services.
本研究旨在探讨那些将患者登记在乳腺癌筛查项目中的全科医生临床活动可能发生的变化。
本研究是一项调查，基于参与研究的全科医生在四周内完成的记录乳房会诊情况的表格。
在全国乳腺癌早期检测试验的三个干预中心之一和三个对照中心之一中进行选择。干预中心位于吉尔福德；对照中心位于特伦特河畔斯托克。
参与者为选定中心的全科医生。在吉尔福德，99名被邀请的全科医生中有64名参与（65%）；在特伦特河畔斯托克，177名中有81名参与（46%）。两个中心的男性和女性参与者比例相似。特伦特河畔斯托克的医生比吉尔福德的医生年龄更大，且在规模较小的诊所工作。
工作量比较显示，在筛查中心，筛查年龄组的患者对医生会诊的需求较少，但被排除在筛查之外的患者更多地利用了全科医生的服务。转诊做法也存在差异，筛查中心的医生更频繁地转诊以获取专科建议。
有证据表明，引入全国性筛查预计不会使全科医疗资源的总体使用发生显著变化，但评估服务可能会面临更大压力。
