Thomas K, Birch S, Milner P, Nicholl J, Westlake L, Williams B
J R Coll Gen Pract. 1989 Dec;39(329):509-13.
This paper reviews four studies sponsored by the Department of Health which have attempted to measure workload in general practice and compares these with data from the general household survey. Despite the considerable differences in the objectives and methods employed by the four studies, they were found to contain remarkably consistent measurements of general practitioner workload. In a 'normal working week' general practitioners spend 38 hours on general medical service duties (including 24 hours of patient contact and five hours of travel to home visits), they see 150 patients or their representatives in surgery, and make 26 home visits. In an 'annual average week', taking into account holidays and sick leave, general practitioners undertake 90% of this workload. The studies show consistently large variations in the workload of general practitioners measured in this way, but fail to identify the key determinants of such variations. The reasons underlying the variation in general practitioner workload will remain unclear until we can distinguish between the expected, measurable variation and the residual, unexplained variation which may be due to the personal preferences of general practitioners.
本文回顾了由卫生部资助的四项研究，这些研究试图衡量全科医疗中的工作量，并将其与一般家庭调查的数据进行比较。尽管这四项研究在目标和采用的方法上存在相当大的差异，但发现它们对全科医生工作量的测量结果非常一致。在“正常工作周”中，全科医生花38小时履行一般医疗服务职责（包括24小时与患者接触以及5小时上门出诊的行程），他们在诊疗室接待150名患者或其代表，并进行26次上门出诊。在“年平均周”中，考虑到节假日和病假，全科医生承担90%的工作量。这些研究一致表明，以这种方式衡量的全科医生工作量存在很大差异，但未能确定这种差异的关键决定因素。在我们能够区分预期的、可测量的差异和可能由于全科医生个人偏好导致的剩余的、无法解释的差异之前，全科医生工作量变化的潜在原因仍将不明。
