Institute for Health and Sport, Victoria University, Australia; Australian Health Policy Collaboration, Victoria University, Australia.
Family Medicine Research Centre, Sydney School of Public Health, University of Sydney, Australia.
J Sci Med Sport. 2019 Apr;22(4):478-483. doi: 10.1016/j.jsams.2018.10.005. Epub 2018 Oct 21.
Physical activity is essential in the primary and secondary prevention of several chronic diseases and should be a standard component of clinical care. The aims of this study were to examine the trends and characteristics of referrals to exercise physiologists in routine care in a nationally representative sample of general practitioners (GPs) in Australia.
This prospective study was an analysis of Bettering the Evaluation and Care of Health (BEACH) GP data from April 2009 to March 2016.
In total, each of 6827 randomly sampled GPs recorded details of 100 consecutive encounters (N=682,700). The rate of exercise physiologist referrals was calculated by patient and GP characteristics.
Over the study period, the rate at which GPs referred their patients significantly increased from 0.38 to 1.44 per 1000 encounters. Patients aged 45-64 years were most likely to be referred (1.32 per 1000 encounters). Patients from non-English-speaking backgrounds were referred at less than half the rate (0.41 per 1000) of those from English speaking backgrounds (0.96). Female GPs referred patients (1.27 per 1000 encounters) twice as often as male GPs (0.64). One-third (35.3%) of GP referrals were made for problems relating to the endocrine, nutritional and metabolic systems (e.g., obesity, diabetes mellitus); only 1.6% of referrals were made for mental health conditions.
Although increasing, the rate of GP referral to exercise physiologists was low and associated with patient and GP characteristics. Education of GPs about the role of exercise physiologists in the prevention and management of chronic disease is needed.
体力活动对于多种慢性病的一级和二级预防至关重要，应成为临床护理的标准组成部分。本研究旨在调查澳大利亚全国代表性的一般执业医师（GP）样本中，常规护理下向运动生理学家转诊的趋势和特征。
这是一项前瞻性研究，对 2009 年 4 月至 2016 年 3 月期间 Bettering the Evaluation and Care of Health（BEACH）GP 数据进行了分析。
共有 6827 名随机抽样 GP 记录了 100 例连续就诊的详细信息（N=682700）。按患者和 GP 特征计算运动生理学家转诊率。
在研究期间，GP 转诊率从 0.38 例/1000 例显著增加至 1.44 例/1000 例。45-64 岁的患者最有可能被转诊（1.32 例/1000 例）。非英语背景的患者转诊率（0.41 例/1000 例）不到英语背景患者（0.96 例/1000 例）的一半。女 GP 转诊患者（1.27 例/1000 例）的频率是男 GP（0.64 例/1000 例）的两倍。三分之一（35.3%）的 GP 转诊是为了与内分泌、营养和代谢系统有关的问题（例如肥胖、糖尿病）；只有 1.6%的转诊是为了心理健康问题。
尽管转诊率在增加，但向运动生理学家转诊的比例仍然较低，且与患者和 GP 特征相关。需要对 GP 进行有关运动生理学家在慢性病预防和管理中作用的教育。
