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基层医疗机构医生对社区服务的认知与使用情况。

Awareness and Use of Community Services among Primary Care Physicians.

机构信息

Family Physician, St. Michael's Hospital, Associate Professor, Department of Family and Community Medicine, Faculty of Medicine and the Institute of Health Policy, Management and Evaluation, University of Toronto, Scientist, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON.

Research Coordinator, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON.

出版信息

Healthc Policy. 2020 Aug;16(1):58-77. doi: 10.12927/hcpol.2020.26290.

Abstract

Primary care physicians play an important role in care coordination, including initiating referrals to community resources. Yet, it is unclear how awareness and use of community resources vary between physicians practising with and without an extended healthcare team. We conducted a cross-sectional survey of primary care physicians practising in Toronto, Canada, to compare awareness and use of community services between physicians practising in team- and non-team-based practice models. Team-based models included Community Health Centres and Family Health Teams - settings in which the government provides funding for the practice to hire non-physician health professionals, such as social workers, pharmacists, nurse practitioners, registered nurses and others. The survey was mailed to physicians, and reminders were done by phone, fax and e-mail. We used logistic regression to compare awareness between physicians in team-based (N = 89) and non-team-based (N = 138) models after controlling for confounders. We found that fewer than half of the physicians were aware of five of eight centralized intake services (e.g., ConnexOntario, Telehomecare). For most services, team-based physicians had at least twice the odds of being aware of the service compared to non-team-based physicians. Our findings suggest that patients in team-based practices may be doubly advantaged, with access to non-physician health professionals within the practice as well as to physicians who are more aware of community resources.

摘要

初级保健医生在协调护理方面发挥着重要作用,包括向社区资源转介。然而,对于在有或没有扩展医疗团队的情况下执业的医生,他们对社区资源的认识和使用情况如何,目前还不清楚。我们对加拿大多伦多的初级保健医生进行了横断面调查,以比较在团队和非团队实践模式下执业的医生对社区服务的认识和使用情况。团队模式包括社区健康中心和家庭健康团队——政府为这些机构提供资金,以便聘请非医生的卫生专业人员,如社会工作者、药剂师、执业护士和其他人员。该调查以邮寄的方式发给医生,并通过电话、传真和电子邮件进行提醒。我们使用逻辑回归来比较团队模式(N=89)和非团队模式(N=138)医生在控制混杂因素后的认识情况。我们发现,不到一半的医生了解八个集中受理服务中的五个(例如 ConnexOntario、Telehomecare)。对于大多数服务,与非团队模式医生相比,团队模式医生对该服务的认识至少有两倍的可能性。我们的研究结果表明,在团队实践中,患者可能会获得双重优势,不仅可以在实践中获得非医生卫生专业人员的帮助,还可以获得对社区资源有更多了解的医生的帮助。

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