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Does risk and urgency of requested out-of-hours general practitioners care differ for people with intellectual disabilities in residential settings compared with the general population in the Netherlands? A cross-sectional routine data-based study.与荷兰一般人群相比,居住在机构中的智障人士对外科医生非工作时间就诊的需求风险和紧迫性是否有所不同?一项基于横断面常规数据的研究。
BMJ Open. 2017 Nov 3;7(11):e019222. doi: 10.1136/bmjopen-2017-019222.
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引用本文的文献

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Utilization and Staff Perspectives on an On-Demand Telemedicine Model for People with Intellectual and Developmental Disabilities Who Reside in Certified Group Residences.居住在经认证的集体住所中的智力和发育障碍者对按需远程医疗模式的使用情况及工作人员观点。
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Healthcare utilisation and unmet health needs in children with intellectual disability: a propensity score matching approach using longitudinal cohort data.利用纵向队列数据采用倾向评分匹配方法评估智障儿童的医疗保健利用情况和未满足的健康需求。
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本文引用的文献

1
Hospital admissions for physical health conditions for people with intellectual disabilities: Systematic review.智力残疾患者的身体健康状况住院治疗情况:系统评价。
J Appl Res Intellect Disabil. 2018 Jan;31 Suppl 1:1-10. doi: 10.1111/jar.12360. Epub 2017 May 3.
2
Cohort profile: a data linkage cohort to examine health service profiles of people with intellectual disability in New South Wales, Australia.队列简介:一个数据关联队列,用于研究澳大利亚新南威尔士州智障人士的健康服务概况。
BMJ Open. 2017 Apr 12;7(4):e015627. doi: 10.1136/bmjopen-2016-015627.
3
Exploring academics' views on designs, methods, characteristics and outcomes of inclusive health research with people with intellectual disabilities: a modified Delphi study.探索学者对与智力残疾者开展包容性健康研究的设计、方法、特征和结果的看法:一项改良德尔菲研究。
BMJ Open. 2016 Aug 18;6(8):e011861. doi: 10.1136/bmjopen-2016-011861.
4
After-hours primary care for people with intellectual disabilities in The Netherlands-Current arrangements and challenges.荷兰为智障人士提供的非工作时间初级医疗服务——当前的安排与挑战
Res Dev Disabil. 2016 Dec;59:1-7. doi: 10.1016/j.ridd.2016.07.007. Epub 2016 Jul 30.
5
Health information exchange for patients with intellectual disabilities: a general practice perspective.智障患者的健康信息交流:全科医疗视角
Br J Gen Pract. 2016 Oct;66(651):e720-8. doi: 10.3399/bjgp16X686593. Epub 2016 Aug 1.
6
Experiences of patients with intellectual disabilities and carers in GP health information exchanges: a qualitative study.智力残疾患者及其照料者在全科医生健康信息交流中的经历:一项定性研究。
Fam Pract. 2016 Oct;33(5):543-50. doi: 10.1093/fampra/cmw057. Epub 2016 Jul 12.
7
Supporting primary healthcare professionals to care for people with intellectual disability: a research agenda.支持初级医疗保健专业人员照料智障人士:一项研究议程。
J Appl Res Intellect Disabil. 2015 Jan;28(1):33-42. doi: 10.1111/jar.12132.
8
Editorial: Health inequity: from evidence to action.
J Appl Res Intellect Disabil. 2015 Jan;28(1):1-2. doi: 10.1111/jar.12136.
9
A systematic review of hospital experiences of people with intellectual disability.对智力残疾者住院经历的系统评价。
BMC Health Serv Res. 2014 Oct 25;14:505. doi: 10.1186/s12913-014-0505-5.
10
The barriers to and enablers of providing reasonably adjusted health services to people with intellectual disabilities in acute hospitals: evidence from a mixed-methods study.急症医院为智障人士提供合理调整的医疗服务的障碍与促进因素:一项混合方法研究的证据
BMJ Open. 2014 Apr 16;4(4):e004606. doi: 10.1136/bmjopen-2013-004606.

与荷兰一般人群相比,居住在机构中的智障人士对外科医生非工作时间就诊的需求风险和紧迫性是否有所不同?一项基于横断面常规数据的研究。

Does risk and urgency of requested out-of-hours general practitioners care differ for people with intellectual disabilities in residential settings compared with the general population in the Netherlands? A cross-sectional routine data-based study.

机构信息

Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.

General Practitioner Cooperative Nijmegen and Boxmeer, Nijmegen, The Netherlands.

出版信息

BMJ Open. 2017 Nov 3;7(11):e019222. doi: 10.1136/bmjopen-2017-019222.

DOI:10.1136/bmjopen-2017-019222
PMID:29101152
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5695369/
Abstract

OBJECTIVES

To investigate whether people with intellectual disabilities (ID) in residential setting were more likely than people from the general population to request out-of-hours general practitioner (GP) care and whether these requests had a similar level of urgency.

DESIGN

Cross-sectional routine data-based study.

SETTING

Two GP cooperatives providing out-of-hours primary care in an area in the Netherlands.

POPULATION

432 582 persons living in the out-of-hours service areas, of which 1448 could be identified as having an ID.

MAIN OUTCOME MEASURES

GP cooperative records of all contacts in 2014 for people with and without ID were used to calculate the relative risk of requesting care and the associated level of urgency.

RESULTS

Of the people with ID (448/1448), 30.9% requested out-of-hours GP care, whereas for the general population this was 18.4% (79 206/431 134), resulting in a relative risk of 1.7 (95% CI 1.6 to 1.8). We found a different distribution of urgency level for people with and without ID. Generally, requests for people with ID were rated as less urgent.

CONCLUSION

People with ID in residential setting were more likely to request out-of-hours GP care than the general population. The distribution of the urgency level of requests differed between the two groups. The high percentage of demands relating to people with ID requesting counselling and advice suggests that some out-of-hours GP care may be avoidable. However, more insight is needed into the nature of out-of-hours primary care requests of people with ID to direct structural and reasonable adjustments towards the improvement of health information exchange in and around-the-clock access to primary care for people with ID.

摘要

目的

调查居住在住宿环境中的智障人士(ID)是否比一般人群更有可能要求在非工作时间寻求全科医生(GP)护理,以及这些请求的紧急程度是否相似。

设计

基于横断面常规数据的研究。

设置

两家提供非工作时间初级保健的全科医生合作社,位于荷兰的一个地区。

人群

居住在非工作时间服务区域的 432582 人,其中 1448 人可以被确定为有 ID。

主要结果测量

使用 2014 年所有与 ID 患者和无 ID 患者接触的 GP 合作社记录,计算要求护理的相对风险以及相关的紧急程度。

结果

ID 患者(448/1448)中有 30.9%请求非工作时间的 GP 护理,而一般人群中这一比例为 18.4%(79206/431134),相对风险为 1.7(95%CI 1.6 至 1.8)。我们发现 ID 患者和无 ID 患者的紧急程度分布不同。一般来说,ID 患者的请求被评为不太紧急。

结论

居住在住宿环境中的 ID 患者比一般人群更有可能要求在非工作时间寻求 GP 护理。这两组人群的请求紧急程度分布不同。ID 患者的大量需求涉及咨询和建议,这表明一些非工作时间的 GP 护理可能是可以避免的。然而,需要更多地了解 ID 患者的非工作时间初级保健请求的性质,以针对改善 ID 患者的健康信息交流和提供 24 小时初级保健,进行结构和合理的调整。