Granja Mónica, Ponte Carla, Cavadas Luís Filipe
S. Mamede de Infesta Health Centre, Matosinhos Local Health Unit, Matosinhos, Portugal.
Porta do Sol Family Health Unit, Matosinhos Local Health Unit, Matosinhos, Portugal.
BMJ Open. 2014 Jun 15;4(6):e005026. doi: 10.1136/bmjopen-2014-005026.
To quantify the time spent by family physicians (FP) on tasks other than direct patient contact, to evaluate job satisfaction, to analyse the association between time spent on tasks and physician characteristics, the association between the number of tasks performed and physician characteristics and the association between time spent on tasks and job satisfaction.
Cross-sectional, using time-and-motion techniques. Two workdays were documented by direct observation. A significance level of 0.05 was adopted.
Multicentric in 104 Portuguese family practices.
A convenience sample of FP, with lists of over 1000 patients, teaching senior medical students and first-year family medicine residents in 2012, was obtained. Of the 217 FP invited to participate, 155 completed the study.
Time spent on tasks other than direct patient contact and on the performance of more than one task simultaneously, the number of direct patient contacts in the office, the number of indirect patient contacts, job satisfaction, demographic and professional characteristics associated with time spent on tasks and the number of different tasks performed, and the association between time spent on tasks and job satisfaction.
FP (n=155) spent a mean of 143.6 min/day (95% CI 135.2 to 152.0) performing tasks such as prescription refills, teaching, meetings, management and communication with other professionals (33.4% of their workload). FP with larger patient lists spent less time on these tasks (p=0.002). Older FP (p=0.021) and those with larger lists (p=0.011) performed fewer tasks. The mean job satisfaction score was 3.5 (out of 5). No association was found between job satisfaction and time spent on tasks.
FP spent one-third of their workday in coordinating care, teaching and managing. Time devoted to these tasks decreases with increasing list size and physician age.
量化家庭医生在直接接触患者以外的任务上所花费的时间，评估工作满意度，分析在任务上花费的时间与医生特征之间的关联、执行任务的数量与医生特征之间的关联以及在任务上花费的时间与工作满意度之间的关联。
采用时间和动作技术的横断面研究。通过直接观察记录两个工作日。采用0.05的显著性水平。
在葡萄牙104个家庭诊所进行多中心研究。
获得了一个便利样本，包括2012年拥有超过1000名患者名单的家庭医生、带教高年级医学生和一年级家庭医学住院医师。在邀请参与的217名家庭医生中，155名完成了研究。
在直接接触患者以外的任务上以及同时执行多项任务上所花费的时间、办公室直接接触患者的次数、间接接触患者的次数、工作满意度、与在任务上花费的时间和执行的不同任务数量相关的人口统计学和专业特征，以及在任务上花费的时间与工作满意度之间的关联。
155名家庭医生平均每天花费143.6分钟（95%可信区间135.2至152.0）执行诸如处方续签、教学、会议、管理以及与其他专业人员沟通等任务（占其工作量的33.4%）。患者名单较长的家庭医生在这些任务上花费的时间较少（p = 0.002）。年龄较大的家庭医生（p = 0.021）和患者名单较长的家庭医生（p = 0.011）执行的任务较少。平均工作满意度得分为3.5（满分5分）。未发现工作满意度与在任务上花费的时间之间存在关联。
家庭医生将三分之一的工作日用于协调护理、教学和管理。随着名单规模和医生年龄的增加，用于这些任务的时间减少。
