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患者与全科医生对就医行为的期望:一项挪威比较研究。

Patients' and GPs' expectations regarding healthcare-seeking behaviour: a Norwegian comparative study.

作者信息

Eide Torunn Bjerve, Straand Jørund, Rosvold Elin Olaug

机构信息

PhD Student, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.

Leader, Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway.

出版信息

BJGP Open. 2018 Nov 14;2(4):bjgpopen18X101615. doi: 10.3399/bjgpopen18X101615. eCollection 2018 Dec.

Abstract

BACKGROUND

GPs are Norwegian patients' first contact point with the healthcare system for most medical problems. However, little is known regarding GPs' expectations towards their patients' healthcare-seeking behaviour, or whether doctors and patients have coinciding expectations of what GPs can do for their patients.

AIM

To investigate patients' and GPs' expectations regarding patients' healthcare-seeking behaviour in primary care, and to make comparisons between the two.

DESIGN & SETTING: Norwegian data from the Quality and Costs of Primary Care in Europe (QUALICOPC) questionnaire study, with information from GPs and their patients.

METHOD

Binary logistic regression was used to investigate associations between expectations, sex and age of GPs and patients, list size, and geographical location of practice. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs). Expectation differences between GPs and patients were analysed using generalised estimating equations (GEEs). Due to multiple testing, Bonferroni correction was used to define significance level at ≤0.002.

RESULTS

In total, 198 GPs (39.1% female) and 1529 patients (61.9% female) responded. No associations with sex or age were found for the GPs' expectations regarding patients' healthcare-seeking behaviour. Among patients, fewer males than females expected that most people would see their GP for sprained ankle (OR 0.7, 95% CI = 0.5 to 0.9), finger cut (OR 0.6, 95% CI = 0.4 to 0.7), smoking cessation (OR 0.6, 95% CI = 0.5 to 0.8), or anxiety (OR 0.4, 95% CI = 0.3 to 0.6). Older patients (aged >65 years) found it more important than younger patients to see a doctor in the presence of medical symptoms. GPs had higher expectations than their patients that people in general would see them for deteriorated vision (OR 4.2, 95% CI = 2.5 to 6.9), sexual problems (OR 1.8, 95% CI =1.3 to 2.6), and anxiety (OR 3.0, 95% CI =1.5 to 6.0).

CONCLUSION

For several common health problems, males are less likely than females to believe that people will see their GP. GPs may overestimate to what degree their patients will see them for a number of common medical problems.

摘要

背景

对于大多数医疗问题,全科医生是挪威患者与医疗保健系统的首个接触点。然而,对于全科医生对患者就医行为的期望,或者医生和患者对于全科医生能为患者做什么是否有一致的期望,我们所知甚少。

目的

调查患者和全科医生对基层医疗中患者就医行为的期望,并对两者进行比较。

设计与设置

来自欧洲基层医疗质量与成本(QUALICOPC)问卷调查研究的挪威数据,包含全科医生及其患者的信息。

方法

采用二元逻辑回归分析期望、全科医生和患者的性别与年龄、名单规模以及执业地理位置之间的关联。结果以比值比(OR)及95%置信区间(CI)呈现。使用广义估计方程(GEE)分析全科医生和患者之间的期望差异。由于进行了多次检验,采用Bonferroni校正将显著性水平定义为≤0.002。

结果

共有198名全科医生(女性占39.1%)和1529名患者(女性占61.9%)做出回应。全科医生对患者就医行为的期望与性别或年龄无关。在患者中,男性比女性更少认为大多数人会因脚踝扭伤(OR 0.7,95% CI = 0.5至0.9)、手指割伤(OR 0.6,95% CI = 0.4至0.7)、戒烟(OR 0.6,95% CI = 0.5至0.8)或焦虑(OR 0.4,95% CI = 0.3至0.6)去看全科医生。老年患者(年龄>65岁)比年轻患者更认为在出现医学症状时看医生很重要。全科医生比患者更期望一般人群会因视力下降(OR 4.2,95% CI = 2.5至6.9)、性问题(OR 1.8,95% CI = 1.3至2.6)和焦虑(OR 3.0,95% CI = 1.5至6.0)来看他们。

结论

对于一些常见健康问题,男性比女性更不太可能认为人们会去看全科医生。全科医生可能高估了患者因一些常见医疗问题找他们看病的程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a54/6348319/4c6c110776db/bjgpopen-1-1615-g001.jpg

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