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匈牙利全科医生使用医疗器械的全国性调查:集群实践模式的优势。

Countrywide survey on utilization of medical devices by GPs in Hungary: advantages of the cluster-practice model.

机构信息

Health Services Management Training Centre, Semmelweis University, Budapest, Hungary.

National Public Health Center, Budapest, Hungary.

出版信息

Prim Health Care Res Dev. 2021 Jun 29;22:e34. doi: 10.1017/S1463423621000372.

Abstract

BACKGROUND

Expectations towards general practitioners (GPs) are continuously increasing to provide a more systematic preventive- and definitive-based care, a wider range of multidisciplinary team-based services and to integrate state-of-the-art digital solutions into daily practice. Aided by development programmes, Hungarian primary care is facing the challenge to fulfil its role as the provider of comprehensive, high quality, patient-centred, preventive care, answering the challenges caused by non-communicable diseases (NCDs).

AIM

The article aims to provide an insight into the utilization of simple, digital, medical devices. We show the relationship between the primary health care (PHC) practice models and the used types of devices. We point at further development directions of GP practices regarding the utilization of evidence-based medical technologies and how such devices support the screening and chronic care of patients with NCDs in everyday practice.

METHODS

Data were collected using an online self-assessment questionnaire from 1800 Hungarian GPs registered in Hungary. Descriptive statistics, Wilcoxon's test and χ2 test were applied to analyze the ownership and utilization of 32 types of medical devices, characteristics of the GP practices and to highlight the differences between traditional and cluster-based operating model.

FINDINGS

Based on the responses from 27.7% of all Hungarian GPs, the medical device infrastructure was found to be limited especially in single GP-practices. Those involved in development projects of GP's clusters in the last decade reported a wider range and significantly more intensive utilization of evidence-based technologies (average number of devices: 5.42 versus 7.56, P<.001), but even these GPs are not using some of their devices (e.g., various point of care testing devices) due to the lack of financing. In addition, GPs involved in GPs-cluster development model programmes showed significantly greater willingness for sharing relatively expensive, extra workforce-demanding technologies (χ2 = 24.5, P<.001).

摘要

背景

人们对全科医生的期望不断提高,希望他们提供更系统的预防和明确的治疗方案,提供更广泛的多学科团队服务,并将最先进的数字解决方案整合到日常实践中。在发展计划的帮助下,匈牙利的初级保健面临着挑战,需要履行其作为提供全面、高质量、以患者为中心、预防保健的提供者的角色,应对非传染性疾病(NCDs)带来的挑战。

目的

本文旨在介绍简单数字医疗设备的使用情况。我们展示了基本医疗保健(PHC)实践模式与使用的设备类型之间的关系。我们指出了 GP 实践在利用基于证据的医疗技术方面的进一步发展方向,以及这些设备如何在日常实践中支持 NCD 患者的筛查和慢性病管理。

方法

使用在线自我评估问卷,从在匈牙利注册的 1800 名匈牙利全科医生中收集数据。采用描述性统计、Wilcoxon 检验和 χ2 检验分析 32 种医疗设备的所有权和使用情况、GP 实践的特点,并突出传统和基于集群的运营模式之间的差异。

结果

根据所有匈牙利全科医生的 27.7%的回复,发现医疗设备基础设施尤其在单一全科医生实践中有限。那些参与过去十年 GP 集群发展项目的医生报告称,他们更广泛、更深入地使用基于证据的技术(平均设备数量:5.42 与 7.56,P<.001),但即使是这些医生也因为缺乏资金而没有使用一些设备(例如,各种即时检验设备)。此外,参与 GP 集群发展模式计划的全科医生表示,他们更愿意共享相对昂贵、需要更多劳动力的技术(χ2 = 24.5,P<.001)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0866/8278792/855a3adf0269/S1463423621000372_fig1.jpg

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