Turner Lyle R, Pearce Christopher, Borg Madeleine, McLeod Adam, Shearer Marianne, Mazza Danielle
Department of General Practice, School of Primary Health Care, Building 1, 270 Ferntree Gully Road, Monash University, Notting Hill, Vic. 3145, Australia.
Melbourne East General Practice Network, 1/5 Lakeside Drive, Burwood East, Vic. 3130, Australia.
Aust J Prim Health. 2017 Jul;23(3):294-299. doi: 10.1071/PY16084.
After-hours access to general practice (GP) is critical to supporting accessibility and reducing emergency department demand. To understand who utilises after-hours GP services, this study examined the characteristics of presentations to an Eastern Melbourne after-hours clinic between 2005 and 2014. Descriptive analyses of patient and presentation characteristics, diagnoses, medications and pathology were conducted. Across the study period, 39.1% of presentations to the clinic (N=64,800) were by patients under 18 years of age. Females were found to attend more often than males, and nearly 79% of patients attended only once. The most common diagnoses were respiratory system diseases (13.4%), gastrointestinal system diseases (12.6%) and eye and ear problems (11.6%). Antibacterial medications accounted for over half (53.0%) of all prescriptions, with 34% of antibiotics prescribed to patients under 18 years of age. Seasonal variation in GP demand was also observed. Presenting patients differed from the wider GP patient population, with more young patients, and a higher proportion of prescriptions for antibacterial medications compared to other predominantly non-after-hours practices. Further research is required to understand the health-seeking, decision-making of patients who utilise after-hours GPs over predominantly non-after-hours primary care services, to inform service promotion and delivery strategies.
下班后获得全科医疗服务对于支持医疗可及性和减少急诊科需求至关重要。为了解谁使用下班后的全科医疗服务，本研究调查了2005年至2014年间墨尔本东部一家下班后诊所的就诊情况。对患者及就诊特征、诊断、用药和病理情况进行了描述性分析。在整个研究期间，该诊所39.1%的就诊患者（N = 64,800）为18岁以下儿童。发现女性就诊频率高于男性，近79%的患者仅就诊一次。最常见的诊断为呼吸系统疾病（13.4%）、胃肠系统疾病（12.6%）以及眼耳问题（11.6%）。抗菌药物占所有处方的一半以上（53.0%），其中34%的抗生素开给了18岁以下患者。还观察到全科医疗需求的季节性变化。前来就诊的患者与更广泛的全科医疗患者群体不同，年轻患者更多，与其他主要为非下班后服务的诊所相比，抗菌药物处方比例更高。需要进一步研究以了解使用下班后全科医疗服务而非主要是非下班后初级保健服务的患者的求医行为和决策过程，为服务推广和提供策略提供依据。
