Eggleton Kyle, Penney Liane, Moore Jenni
Department of General Practice and Primary Health Care, The University of Auckland, New Zealand.
Northland District Health Board, New Zealand.
J Prim Health Care. 2017 Mar;9(1):56-61. doi: 10.1071/HC16036.
INTRODUCTION Primary care access is associated with improved patient outcomes. Availability of appointments in general practice is one measure of access. Northland's demographics and high ambulatory sensitive hospitalisation rates may indicate constrained appointment availability. Our study aims were to determine appointment availability and establish the feasibility of measuring appointment availability through an automated process. METHODS An automated electronic query was created, run through a third party software programme that interrogated Northland general practice patient management systems. The time to third next available appointment (TNAA) was calculated for each general practitioner (GP) and a mean calculated for each practice and across the region. A research assistant telephone request for an urgent GP appointment captured the time to the urgent appointment and type of urgent appointment used to fit patients in. Regression analysis was used to determine the relationships between deprivation, patients per GP, and the use of walk-in clinics. RESULTS The mean TNAA was 2.5 days. 12% of practices offered walk-in clinics. There was a significant relationship between TNAA and increasing number of walk-in clinics. CONCLUSION The TNAA of 2.5 days indicates the possibility that routine appointments are constrained in Northland. However, TNAA may not give a reliable measure of urgent appointment availability and the measure needs to be interpreted by taking into account practice characteristics. Walk-in clinics, although increasing the availability of urgent appointments, may lead to more pressure on routine appointments. Using an electronic query is a feasible way to measure routine GP appointment availability.
基层医疗服务的可及性与改善患者治疗效果相关。全科医疗预约的可获得性是衡量可及性的一项指标。北地大区的人口结构以及较高的非卧床敏感型住院率可能表明预约可获得性受限。我们的研究目的是确定预约可获得性,并通过自动化流程确定测量预约可获得性的可行性。
创建了一个自动化电子查询,通过第三方软件程序运行,该程序查询北地大区全科医疗患者管理系统。计算每位全科医生(GP)到第三次下一次可预约时间(TNAA),并计算每个诊所及整个地区的平均值。一名研究助理通过电话请求紧急全科医生预约,记录获得紧急预约的时间以及用于安排患者就诊的紧急预约类型。采用回归分析来确定贫困程度、每位全科医生的患者数量以及随诊诊所使用情况之间的关系。
平均TNAA为2.5天。12%的诊所提供随诊服务。TNAA与随诊诊所数量增加之间存在显著关系。
2.5天的TNAA表明北地大区常规预约可能受到限制。然而,TNAA可能无法可靠衡量紧急预约的可获得性,该指标需要结合诊所特征进行解读。随诊诊所虽然增加了紧急预约的可获得性,但可能给常规预约带来更大压力。使用电子查询是测量全科医生常规预约可获得性的一种可行方法。