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澳大利亚全科医生和可赔偿患者:影响索赔管理和重返工作的因素。

Australian General Practitioners' and Compensable Patients: Factors Affecting Claim Management and Return to Work.

机构信息

Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, 3004, Australia.

Department of General Practice, Monash University, 1/270 Ferntree Gully Rd, Notting Hill, 3168, Australia.

出版信息

J Occup Rehabil. 2019 Dec;29(4):672-678. doi: 10.1007/s10926-019-09828-3.

Abstract

Purpose General Practitioners (GPs) play an important role in personal injury compensation systems yet system processes have been perceived as burdensome. Objectives were to (1) determine attitudes of Australian GPs on health benefits of return to work (RTW) after injury/illness and (2) identify associations between GP characteristics and agreement with issues surrounding treating compensable patients. Methods Cross-sectional postal survey of 423 Australian GPs to determine agreement with issues associated with compensable patients (including patient advocacy, conflicting opinions between GPs and compensation systems, fitness-for-work certification, and refusal to treat). Results The vast majority of GPs agreed there was a health benefit to early RTW. GPs with 16-20 years' experience had significantly higher odds of agreeing that the certificate of work capacity is the primary method of communication between RTW stakeholders (OR 2.36 [1.13-4.92]) than those with greater experience. 49% of GPs agreed they should be able to refuse to treat compensable patients. Female GPs had significantly lower odds (OR 0.60 [0.40-0.90]) of agreeing with right to refuse than male GPs, as did those from remote or regional practices (OR 0.43 [0.20-0.94]; OR 0.60 [0.39-0.92]) than GPs from urban practices. Conclusions Reducing administrative barriers identified by Australian GPs and improving communication with compensation systems will likely have a positive impact on their refusal to treat compensable patients.

摘要

目的

全科医生在人身伤害赔偿制度中扮演着重要的角色,但系统流程被认为是繁琐的。本研究旨在:(1)确定澳大利亚全科医生对受伤/患病后重返工作岗位(RTW)的健康益处的态度;(2)确定全科医生的特征与对与处理可赔偿患者相关问题的意见之间的关系。

方法

对 423 名澳大利亚全科医生进行横断面邮寄调查,以确定他们对与可赔偿患者相关问题的意见(包括患者倡导、全科医生与赔偿制度之间的意见冲突、工作能力认证以及拒绝治疗)。

结果

绝大多数全科医生认为早期 RTW 对健康有益。与经验更丰富的全科医生相比,具有 16-20 年经验的全科医生更有可能同意工作能力证明是 RTW 利益相关者之间主要沟通方式(OR 2.36 [1.13-4.92])。49%的全科医生同意他们应该能够拒绝治疗可赔偿的患者。与男性全科医生相比,女性全科医生(OR 0.60 [0.40-0.90])更不可能同意拒绝治疗的权利,而来自偏远或地区实践的全科医生(OR 0.43 [0.20-0.94];OR 0.60 [0.39-0.92])比来自城市实践的全科医生更不可能同意。

结论

减少澳大利亚全科医生认为的行政障碍,并改善与赔偿制度的沟通,可能会对他们拒绝治疗可赔偿患者产生积极影响。

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