Magin Parker, Catzikiris Nigel, Tapley Amanda, Morgan Simon, Holliday Elizabeth G, Ball Jean, Henderson Kim, Elliott Taryn, Regan Cathy, Spike Neil
School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia,
GP Synergy, Newcastle, New South Wales, Australia.
Fam Pract. 2017 Feb;34(1):77-82. doi: 10.1093/fampra/cmw099. Epub 2016 Sep 14.
Home visits (HVs) and nursing home visits (NHVs) are accepted as core elements of general practice. There is concern regarding declining rates of HVs and an increasing demand for NHVs together with a perceived decreased willingness of younger GPs to provide these services.
To establish the prevalence and associations of recently vocationally qualified GPs ('graduates') performing HVs and NHVs.
A cross-sectional questionnaire-based study of recent (within 5 years) graduates of 3 of Australia's 17 regional general practice training programs. Outcome factors were performing, as part of current practice, HVs and NHVs. Factors associated with each outcome were assessed by logistic regression with graduate and current practice characteristics and vocational training experiences as independent variables.
Of 230 responding graduates, 48.1% performed HVs and 40.6% performed NHVs in their current clinical GP role. Factors associated with both HVs and NHVs were participating in in-practice clinical teaching/supervision [odds ratios (ORs) 2.65 and 2.66], conducting HVs/NHVs during training (ORs 5.05 and 10.8) and working full-time (ORs for part-time work 0.20 and 0.29). Further associations with performing HVs were older GP age (compared to <36 years: ORs 3.65 for 36-40 and 2.53 for 41+), smaller practice size (OR 0.53 for larger practices), Australian undergraduate education (OR 0.31 for non-Australian) and greater number of years in their current practice as a qualified GP (OR 1.25 per year).
Our findings of graduates' modest engagement with HVs and NHVs reinforce concerns regarding Australian general practice's capacity to accommodate the needs of an aging population.
家访（HV）和疗养院访视（NHV）被视为全科医疗的核心要素。人们担心家访率下降，对疗养院访视的需求增加，同时感觉年轻全科医生提供这些服务的意愿降低。
确定近期获得职业资格的全科医生（“毕业生”）进行家访和疗养院访视的患病率及相关因素。
对澳大利亚17个地区全科医疗培训项目中的3个项目的近期（5年内）毕业生进行基于问卷的横断面研究。结果因素是作为当前执业的一部分进行家访和疗养院访视。通过逻辑回归评估与每个结果相关的因素，将毕业生及当前执业特征和职业培训经历作为自变量。
在230名回复的毕业生中，48.1%在其当前全科医疗临床角色中进行家访，40.6%进行疗养院访视。与家访和疗养院访视均相关的因素包括参与临床实践教学/督导[优势比（OR）分别为2.65和2.66]、在培训期间进行家访/疗养院访视（OR分别为5.05和10.8）以及全职工作（兼职工作的OR分别为0.20和0.29）。与进行家访进一步相关的因素包括全科医生年龄较大（与<36岁相比：36 - 40岁的OR为3.65，41岁及以上的为2.53）、执业规模较小（大型执业的OR为0.53）、澳大利亚本科教育背景（非澳大利亚背景的OR为0.31）以及作为合格全科医生在当前执业中的年限增加（每年的OR为1.25）。
我们关于毕业生对家访和疗养院访视参与程度不高的研究结果，强化了对澳大利亚全科医疗满足老年人口需求能力的担忧。
