Department of Public Health Sciences, University of Turin, Piazza Polonia, 94, 10126, Torino, Italy.
Department of Surgery, Northwestern University, Feinberg School of Medicine, 633 N. St Clair Street, Chicago, IL, 60611, USA.
BMC Fam Pract. 2020 Mar 17;21(1):54. doi: 10.1186/s12875-020-01124-x.
The communication of relevant patient information between general practitioners (GPs) and medical specialists is important in order to avoid fragmentation of care thus achieving a higher quality of care and ensuring physicians' and patients' satisfaction. However, this communication is often not carried out properly. The objective of this study is to assess whether communication between GPs and medical specialists in the referral process is associated with the organisation of primary care within a country, the characteristics of the GPs, and the characteristics of the primary care practices themselves.
An analysis of a cross-sectional survey among GPs in 34 countries was conducted. The odds ratios of the features that were expected to relate to higher rates of referral letters sent and communications fed back to GPs were calculated using ordered logistic multilevel models.
A total of 7183 GPs from 34 countries were surveyed. Variations between countries in referral letters sent and feedback communication received did occur. Little of the variance between countries could be explained. GPs stated that they send more referral letters, and receive more feedback communications from medical specialists, in countries where they act as gatekeepers, and when, in general, they interact more with specialists. GPs reported higher use of referral letters when they had a secretary and/or a nurse in their practice, used health information technologies, and had greater job satisfaction.
There are large differences in communication between GPs and medical specialists. These differences can partly be explained by characteristics of the country, the GP and the primary care practice. Further studies should also take the organisation of secondary care into account.
为避免医疗服务碎片化，从而提高医疗质量并确保医生和患者的满意度，全科医生（GP）与医学专家之间应充分交流相关患者信息。然而，这种交流往往没有得到妥善进行。本研究旨在评估在转诊过程中 GP 与医学专家之间的沟通是否与国家内初级保健的组织、GP 的特征以及初级保健实践本身的特征有关。
对 34 个国家的 GP 进行了横断面调查分析。使用有序逻辑多层模型计算了预计与转诊信发送率和反馈给 GP 的沟通率较高相关的特征的优势比。
共调查了来自 34 个国家的 7183 名 GP。国家之间在转诊信发送和反馈沟通方面存在差异。国家间的差异很小。GP 表示，在充当守门人、与专家互动更多的国家，他们会发送更多的转诊信，并收到更多来自医学专家的反馈沟通。当 GP 的实践中有秘书和/或护士、使用健康信息技术以及工作满意度更高时，他们会更多地使用转诊信。
GP 与医学专家之间的沟通存在很大差异。这些差异部分可以通过国家、GP 和初级保健实践的特征来解释。进一步的研究还应考虑二级保健的组织情况。
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