Adar Tamar, Levkovich Inbar, Castel Orit Cohen, Karkabi Khaled
1 Technion-Israel Institute of Technology, Haifa, Israel.
2 Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel.
J Prim Care Community Health. 2017 Oct;8(4):221-227. doi: 10.1177/2150131917734473. Epub 2017 Oct 14.
Data on patients' utilization of health services in primary care is relevant to planning healthcare. Data may be collected by numerous methods, but obtaining a true picture of content of care has practical difficulties.
To describe patient's reasons for visits to primary care physicians (PCPs) as presented by the patient; and to examine the effect of patient-, doctor- and clinic-related variables on the reasons for the visit.
Visits to PCPs were observed by peer doctors during 2014, at primary care clinics in Israel. Data were collected on characteristics of physicians, patients, clinics, type of visit, and reasons for visit.
Eleven physicians from 7 clinics participated in the study. Data were gathered from 327 visits. Patients visited for a wide variety of reasons. The most common acute complaints were upper respiratory symptoms, gastrointestinal, skin symptoms, and back and neck problems. The most common chronic complaints were hypertension and diabetes. Patients presented with administrative requests in 36% of visits; 15% were for solely administrative issues. A total of 26.6% of visits included requests for blood tests or discussion of tests. Patients initiated preventive medicine issues in 5% of visits. Visits for chronic problems were directly correlated with patient age and the extent of acquaintance with the physician. Gender-associated differences were also found: women were more likely to visit for a new medical problem than men, while men were more likely to visit for known or chronic problems.
Patients visit their PCP for a wide variety of reasons, often during the same visit. Patients refer for administrative requests in about a third of visits. They initiate preventive care infrequently (1 out of 20 visits). To further characterize patient utilization of primary care, a broader study needs to be performed.
关于患者在初级保健中使用卫生服务的数据与医疗保健规划相关。数据可通过多种方法收集，但要全面了解医疗服务内容存在实际困难。
描述患者向初级保健医生（PCP）就诊时自述的就诊原因；并研究患者、医生和诊所相关变量对就诊原因的影响。
2014年，以色列初级保健诊所的同行医生对患者就诊情况进行了观察。收集了医生、患者、诊所的特征、就诊类型和就诊原因等数据。
来自7家诊所的11名医生参与了该研究。收集了327次就诊的数据。患者就诊原因多种多样。最常见的急性症状是上呼吸道症状、胃肠道症状、皮肤症状以及背部和颈部问题。最常见的慢性疾病是高血压和糖尿病。36%的就诊涉及行政事务请求；15%的就诊完全是出于行政事务。总共26.6%的就诊包括血液检查请求或对检查的讨论。5%的就诊涉及预防医学问题。因慢性问题就诊与患者年龄和与医生的熟悉程度直接相关。还发现了性别差异：女性因新的医疗问题就诊的可能性高于男性，而男性因已知或慢性问题就诊的可能性更高。
患者因多种原因就诊，且往往在同一次就诊中涉及多种原因。约三分之一的就诊涉及行政事务请求。他们很少主动进行预防保健（20次就诊中有1次）。为了进一步描述患者对初级保健的利用情况，需要进行更广泛的研究。
