Murphy M, Brodie G, Byrne S, Bradley C
Department of General Practice, School of Medicine, University College Cork, Cork, Ireland,
Ir J Med Sci. 2015 Mar;184(1):147-52. doi: 10.1007/s11845-014-1078-3. Epub 2014 Feb 20.
The reasons why patients visit their general practitioner (GP) is vital information for fund holders and policy makers. GP consultations in the Republic of Ireland are either paid by the patient on a fee-per-service basis (private patients) or by the state [general medical service (GMS) card holders], and information related to primary care consultations is limited.
The aim of this study was to conduct an observational study of GMS and private consultations within general practice in Ireland.
This is a cross-sectional study of general practitioner consultations.
GPs within existing Continued Medical Education (CME) groups were invited to participate. Participating GPs gathered data on 100 consecutive consultations between September 2008 and April 2010.
There were 16,899 consultations recorded; 53.8 % (9,095) were GMS patients. Patients ≥65 years accounted for 23.69 % of consultations (n = 3,822). Respiratory illnesses accounted for the highest proportion of consultations (3,886, 23.0 %), followed by routine check-ups (15.4 %). GMS patients were more likely to consult for a repeat prescription (OR = 4.04, 95 % CI 2.93-5.57) and were also more likely to consult to review their treatment (OR = 2.33, 95 % CI 1.68-3.22) compared to private patients.
This study displays the consultation behaviour of patients in Ireland. It suggests that inequalities may exist in access to primary care services in ROI; however, more research is required to examine this further. There is insufficient information available on primary healthcare utilisation. Key issues such as the lack of unique patient identifiers and the lack of extractable data from GP practices in ROI need to be addressed.
患者就诊于全科医生（GP）的原因对于资金持有者和政策制定者来说是至关重要的信息。在爱尔兰共和国，全科医生诊疗要么由患者按服务收费支付（私人患者），要么由国家支付（一般医疗服务（GMS）卡持有者），且与初级保健诊疗相关的信息有限。
本研究的目的是对爱尔兰全科医疗中的GMS和私人诊疗进行一项观察性研究。
这是一项关于全科医生诊疗的横断面研究。
邀请现有继续医学教育（CME）小组中的全科医生参与。参与的全科医生收集了2008年9月至2010年4月期间连续100次诊疗的数据。
共记录了16,899次诊疗；53.8%（9,095次）是GMS患者。65岁及以上患者占诊疗次数的23.69%（n = 3,822）。呼吸系统疾病占诊疗次数的比例最高（3,886次，23.0%），其次是常规检查（15.4%）。与私人患者相比，GMS患者更有可能因重复开药而就诊（比值比（OR）= 4.04，95%置信区间（CI）2.93 - 5.57），也更有可能因复查治疗而就诊（OR = 2.33，95% CI 1.68 - 3.22）。
本研究展示了爱尔兰患者的诊疗行为。这表明在爱尔兰共和国获得初级保健服务方面可能存在不平等；然而，需要更多研究来进一步探讨这一点。关于初级医疗保健利用的可用信息不足。需要解决一些关键问题，如缺乏唯一的患者标识符以及无法从爱尔兰共和国的全科医生诊所提取数据等问题。
