Lynn An-Min, Shih Tzu-Chien, Hung Cheng-Hao, Lin Ming-Hwai, Hwang Shinn-Jang, Chen Tzeng-Ji
Department of Family Medicine, Taipei Veterans General Hospital , Taipei , Taiwan.
PeerJ. 2015 Aug 6;3:e1145. doi: 10.7717/peerj.1145. eCollection 2015.
Although family medicine (FM) is the most commonly practiced specialty among all the medical specialties, its practice patterns have seldom been analyzed. Looking at data from Taiwan's National Health Insurance Research Database, the current study analyzed ambulatory visits to FM specialists nationwide. From a sample dataset that randomly sampled one out of every 500 cases among a total of 309,880,000 visits in 2012, it was found that 18.8% (n = 116, 551) of the 619,760 visits in the dataset were made to FM specialists. Most of the FM services were performed by male FM physicians. Elderly patients above 80 years of age accounted for only 7.1% of FM visits. The most frequent diagnoses (22.8%) were associated acute upper respiratory infections (including ICD 460, 465 and 466). Anti-histamine agents were prescribed in 25.6% of FM visits. Hypertension, diabetes and dyslipidemia were the causes of 20.7% of the ambulatory visits made to FM specialists of all types, while those conditions accounted for only 10.6% of visits to FM clinics. The study demonstrated the relatively low proportion of chronic diseases that was managed in FM clinics in Taiwan, and our detailed results could contribute to evidence-based discussions on healthcare policymaking and residency training.
尽管家庭医学(FM)是所有医学专科中最常实践的专科,但其实践模式很少被分析。通过查看台湾国民健康保险研究数据库的数据,本研究分析了全国范围内家庭医学专科医生的门诊就诊情况。从2012年总计3.0988亿次就诊中每500例随机抽取1例的样本数据集中发现,该数据集中619760次就诊中有18.8%(n = 116551)是看家庭医学专科医生。大多数家庭医学服务由男性家庭医学医生提供。80岁以上的老年患者仅占家庭医学就诊的7.1%。最常见的诊断(22.8%)是急性上呼吸道感染(包括国际疾病分类460、465和466)。25.6%的家庭医学就诊开具了抗组胺药。高血压、糖尿病和血脂异常是所有类型家庭医学专科医生门诊就诊的20.7%的病因,而这些疾病在家庭医学诊所就诊中仅占10.6%。该研究表明台湾家庭医学诊所管理的慢性病比例相对较低,我们的详细结果有助于为医疗保健政策制定和住院医师培训的循证讨论提供参考。