Bonney Andrew, Morgan Simon, Tapley Amanda, Henderson Kim, Holliday Elizabeth, Davey Andrew, van Driel Mieke, Spike Neil, Regan Cathy, Ball Jean, Magin Parker
School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
Elermore Vale General Practice, Newcastle, New South Wales, Australia.
Australas J Ageing. 2017 Mar;36(1):E1-E7. doi: 10.1111/ajag.12364. Epub 2016 Nov 22.
To investigate older patients' encounters with general practice registrars (GPRs) to inform training and clinical practice.
Cross-sectional analysis of data from GPR consultations across five regional training providers in Australia. Data were analysed using simple and multiple logistic regression models.
Our analysis included details of 118 831 consultations, 20 555 (17.6%, 95% CI 17.4-17.8) with patients aged ≥65 years. Older patient encounters had an increased likelihood of including chronic disease (OR 1.77, 95% CI 1.70, 1.86) and more problems (OR 1.24, 95% CI 1.20, 1.27). However, in-consultation information or advice was less likely to be sought (OR 0.92, 95% CI 0.88, 0.97), and consultations were briefer (OR 0.99, 95% CI 0.99, 1.00).
Our results suggest relatively limited GPR exposure to older patients coupled with less complex consultations than expected. Solutions will need to be carefully constructed not only to increase caseloads, but also to address training and supervision concerns.
调查老年患者与全科实习医生（GPR）的接触情况，为培训和临床实践提供参考。
对澳大利亚五个地区培训提供者的GPR会诊数据进行横断面分析。使用简单和多元逻辑回归模型分析数据。
我们的分析包括118831次会诊的详细信息，其中20555次（17.6%，95%CI 17.4 - 17.8）是与65岁及以上患者的会诊。老年患者会诊中包含慢性病的可能性增加（比值比[OR]1.77，95%CI 1.70，1.86），且问题更多（OR 1.24，95%CI 1.20，1.27）。然而，会诊期间寻求信息或建议的可能性较小（OR 0.92，95%CI 0.88，0.97），会诊时间也较短（OR 0.99，95%CI 0.99，1.00）。
我们的结果表明，GPR接触老年患者的机会相对有限，且会诊复杂性低于预期。需要精心制定解决方案，不仅要增加工作量，还要解决培训和监督方面的问题。
