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在不断变化的基于医师办公室的门诊护理环境中收集实践层面的数据:一项关于《国家门诊医疗护理调查》医师入职访谈部分的试点研究

Collecting Practice-level Data in a Changing Physician Office-based Ambulatory Care Environment: A Pilot Study Examining the Physician induction interview Component of the National Ambulatory Medical Care Survey.

作者信息

Halley Meghan C, Rendle Katharine A, Gugerty Brian, Lau Denys T, Luft Harold S, Gillespie Katherine A

出版信息

Vital Health Stat 2. 2017 Nov(176):1-18.

Abstract

Objective This report examines ways to improve National Ambulatory Medical Care Survey (NAMCS) data on practice and physician characteristics in multispecialty group practices. Methods From February to April 2013, the National Center for Health Statistics (NCHS) conducted a pilot study to observe the collection of the NAMCS physician interview information component in a large multispecialty group practice. Nine physicians were randomly sampled using standard NAMCS recruitment procedures; eight were eligible and agreed to participate. Using standard protocols, three field representatives conducted NAMCS physician induction interviews (PIIs) while trained ethnographers observed and audio recorded the interviews. Transcripts and field notes were analyzed to identify recurrent issues in the data collection process. Results The majority of the NAMCS items appeared to have been easily answered by the physician respondents. Among the items that appeared to be difficult to answer, three themes emerged: (a) physician respondents demonstrated an inconsistent understanding of "location" in responding to questions; (b) lack of familiarity with administrative matters made certain questions difficult for physicians to answer; and (c) certain primary care‑oriented questions were not relevant to specialty care providers. Conclusions Some PII survey questions were challenging for physicians in a multispecialty practice setting. Improving the design and administration of NAMCS data collection is part of NCHS' continuous quality improvement process.

摘要

目的 本报告探讨了改进国家门诊医疗护理调查(NAMCS)中关于多专科团体医疗实践的执业情况和医生特征数据的方法。方法 2013年2月至4月,国家卫生统计中心(NCHS)开展了一项试点研究,以观察在一个大型多专科团体医疗实践中收集NAMCS医生访谈信息部分的情况。使用标准的NAMCS招募程序随机抽取了9名医生;其中8名符合条件并同意参与。按照标准方案,3名现场代表进行了NAMCS医生入职访谈(PII),同时训练有素的人种志学者对访谈进行观察和录音。对访谈记录和现场笔记进行分析,以确定数据收集过程中反复出现的问题。结果 大多数NAMCS项目似乎都能被医生受访者轻松回答。在那些似乎难以回答的项目中出现了三个主题:(a)医生受访者在回答问题时对“地点”的理解不一致;(b)对行政事务不熟悉使得某些问题对医生来说难以回答;(c)某些以初级保健为导向的问题与专科护理提供者无关。结论 在多专科医疗实践环境中,一些PII调查问题对医生来说具有挑战性。改进NAMCS数据收集的设计和管理是NCHS持续质量改进过程的一部分。

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