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潜在的初级保健急诊服务与新南威尔士州全科医生护理利用之间的关联。

Association between potential primary care emergency service and general practitioner care utilisation in New South Wales.

机构信息

System Information and Analytics Branch, NSW Ministry of Health, Sydney, New South Wales, Australia.

出版信息

Emerg Med Australas. 2021 Feb;33(1):52-57. doi: 10.1111/1742-6723.13564. Epub 2020 Jun 28.

Abstract

OBJECTIVE

To examine patterns of potential primary care (PPC) ED presentations and any association between PPC ED presentations and frequency of general practitioner (GP) care utilisation in New South Wales, Australia.

METHODS

Retrospective cross-sectional study of 6 221 762 New South Wales patients who had at least one service in public hospitals, EDs or Medical Benefit Schedule claimable for GP service between 2013/2014 and 2014/2015 is conducted to examine association between PPC ED presentations and GP care utilisation using logistic regression adjusting for comorbidity index and a number of other covariates. Data over 2010/2011 to 2014/2015 are included for analyses of trends and patterns in PPC ED and GP care utilisation.

RESULTS

Forty-one percent of the ED presentations were PPC ED presentations over the 5 years 2010/2011 to 2014/2015. Population rates of PPC ED presentations and GP care both increased over the period, with higher PPC ED presentation rates in regional areas, and higher GP care rates in major cities. GP care utilisation was associated with reduced odds for PPC ED presentations, with the adjusted odds ratios ranging from 0.28 for patients with one GP care service to 0.48 for patients with five or more GP care services compared with patients with none. Increased comorbidity index was also associated with increased risk of PPC ED presentations.

CONCLUSION

GP care utilisation was associated with reduced risk for any PPC ED presentations after adjusting for comorbidity index and the other factors.

摘要

目的

考察澳大利亚新南威尔士州潜在初级保健(PPC)急诊就诊模式,以及 PPC 急诊就诊与全科医生(GP)就诊频率之间的关联。

方法

本研究采用回顾性横断面研究方法,对 2013/2014 年至 2014/2015 年期间至少在公立医院、急诊或可报销 GP 服务的医疗福利计划中有一次就诊记录的 6221762 名新南威尔士州患者进行研究,目的是使用 logistic 回归调整共病指数和其他一些协变量,以检验 PPC 急诊就诊与 GP 护理利用之间的关联。纳入了 2010/2011 年至 2014/2015 年的数据,以分析 PPC 急诊和 GP 护理利用的趋势和模式。

结果

在 2010/2011 年至 2014/2015 年的 5 年中,41%的急诊就诊为 PPC 急诊就诊。在此期间,人口中 PPC 急诊就诊率和 GP 护理利用率均有所增加,区域地区的 PPC 急诊就诊率较高,主要城市的 GP 护理利用率较高。GP 护理利用率与 PPC 急诊就诊的可能性降低相关,调整后的比值比范围为 1 次 GP 护理服务患者为 0.28,5 次或更多 GP 护理服务患者为 0.48,与无 GP 护理服务患者相比。共病指数增加也与 PPC 急诊就诊的风险增加相关。

结论

在调整共病指数和其他因素后,GP 护理利用率与任何 PPC 急诊就诊的风险降低相关。

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