Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia.
Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; and Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, NSW 2006, Australia; and Corresponding author. Email:
Aust J Prim Health. 2020 Apr;26(2):117-123. doi: 10.1071/PY19169.
After-hours general practitioner (GP) services can reduce emergency department demand, which is currently increasing in Australia. Understanding GP after-hours care may assist in service planning. From April 2014 to March 2015, 986 GPs recorded 38275 consultations with start and finish times in the Bettering the Evaluation and Care of Health (BEACH) study, a national, cross-sectional, representative study of GP activity. GP and patient characteristics and the content of encounters in usual-hours and after-hours were compared. Significantly more after-hours than usual-hours encounters were with: GPs aged 60+ years; in metropolitan practices; and practices with 10+ GPs. Patients seen after-hours were more often: male; aged 15-64 years; new to practice; and less likely to hold a Commonwealth Concession Card. They were more likely to be prescribed antibiotics and less likely to: have chronic problems managed; be referred; receive psycholeptic or psychoanaleptic prescription; and undergo a procedure. Throat symptoms, fever and injury were more common reasons for encounter, while infections and injury were more frequently managed problems after-hours. The patient mix, GP characteristics, problems managed and management actions in after-hours care differ from those in usual-hours care in Australia. This greater understanding of after-hours care is the first step to informed resource allocation to improve the delivery of after-hours primary care.
下班后的全科医生（GP）服务可以减少澳大利亚目前不断增加的急诊需求。了解下班后的全科医生护理可能有助于服务规划。从 2014 年 4 月至 2015 年 3 月，在全国性的、横断面的、具有代表性的全科医生活动研究——改善医疗保健评估和护理（BEACH）研究中，986 名全科医生记录了 38275 次就诊，这些就诊有开始和结束时间。比较了通常工作时间和下班后的全科医生和患者特征以及就诊内容。与通常工作时间相比，下班后有更多的就诊：由 60 岁以上的全科医生接诊；在大都市行医；以及有 10 名以上全科医生的行医。下班后就诊的患者更常见为：男性；年龄在 15-64 岁之间；是新来的；不太可能持有联邦优惠卡。他们更有可能被开抗生素，不太可能：患有慢性病；转诊；开精神类药物处方；进行手术。喉咙痛、发烧和受伤是更常见的就诊原因，而感染和受伤则更常被作为下班后的治疗问题。澳大利亚，患者构成、全科医生特征、管理的问题和下班后护理的管理措施与通常工作时间护理不同。这种对下班后护理的更多了解是为了更明智地分配资源以改善下班后初级保健服务的第一步。
