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新注册的老年患者:他们是谁,为何病历转移会如此延迟?

Newly registered elderly patients: who are they and why such delay in the transfer of their medical records?

作者信息

Graham H J, Livesley B

机构信息

Clinical Gerontology Research Unit, Dulwich Hospital, London.

出版信息

Br Med J (Clin Res Ed). 1988 Jan 30;296(6618):340-2. doi: 10.1136/bmj.296.6618.340.

Abstract

The time taken to transfer the records of elderly patients registering with a new general practice was investigated. Thirty five (5%) of a total of 671 patients aged 75 and over were entered as new patients on to the age-sex register of an urban group practice during one year. Twenty nine had moved into the area and six had changed their general practitioner for personal and other reasons. An average of 141 (range 71-296) days elapsed before dispatch of their medical records to the new practice. During this period an average of 3.5 (range 0-15) consultations with a general practitioner were recorded, indicating the need of such patients for medical care. The long delays were caused by the processing of medical records at the central register and the transfer of records between family practitioner committees and general practitioners. Delays were most apparent in the time taken for general practitioners to dispatch the necessary documents to the family practitioner committees, and these should be minimised. The use of a summary card written and updated by the general practitioner and retained by the patient would facilitate continuing care should patients change to a new practice. Meanwhile, assessment of elderly patients after registration with a new practice by a member of the primary health care team may identify problems before the records have been transferred and may help the resettlement of these high risk elderly patients.

摘要

对老年患者在新的全科诊所注册时病历转移所需时间进行了调查。在一年时间里,城市团体诊所年龄性别登记册上登记的671名75岁及以上患者中,有35名(5%)被登记为新患者。其中29人搬到了该地区,6人因个人或其他原因更换了全科医生。在将他们的病历发送到新诊所之前,平均过去了141天(范围为71 - 296天)。在此期间,平均记录到与全科医生进行了3.5次(范围为0 - 15次)会诊,表明这类患者需要医疗护理。长时间的延迟是由中央登记处病历处理以及家庭医生委员会和全科医生之间病历转移造成的。延迟在全科医生向家庭医生委员会发送必要文件所需时间上最为明显,应尽量减少这些延迟。使用由全科医生书写并更新、由患者保留的摘要卡,在患者更换到新诊所时将有助于持续护理。同时,初级卫生保健团队成员在老年患者在新诊所注册后进行评估,可能在病历转移之前发现问题,并可能有助于这些高危老年患者的重新安置。

引用本文的文献

1
Transfer of medical records.病历转移
J R Coll Gen Pract. 1988 Dec;38(317):569.
2
Newly registered elderly patients.新登记的老年患者。
Br Med J (Clin Res Ed). 1988 Mar 12;296(6624):788-9. doi: 10.1136/bmj.296.6624.788-c.

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