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澳大利亚首都地区的社区基层医疗保健的非工作时间讲座。

After-hours presentations to community-based primary care in the Australian Capital Territory.

机构信息

Academic Unit of General Practice, Office of Professional Leadership and Education, ACT Health Directorate, Canberra, ACT, Australia; and Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.

Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; and Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.

出版信息

Aust J Prim Health. 2022 Jun;28(3):232-238. doi: 10.1071/PY21261.

Abstract

This study describes patient characteristics and presentations to community-based primary care medical services in the after-hours period. A cross-sectional survey completed by practitioners was voluntarily conducted over one weeknight and weekend in 2019 at 31 of 51 extended hours general practices (GP), three of three medical deputising services and three of three nurse-led walk-in clinics (WICs). Of 3371 community-based after-hours presentations, 934 consultation records were obtained (overall response: 28%). Emergency departments reported 524 triage code 4 and 5 patients within the study period. Problems managed in community-based after-hours services were most often rated as non-urgent (n = 482; 51.6%) and new (n = 606; 64.9%). The most common community-based after-hours presentations were diagnostic or disease related (e.g. infections or injury; n = 667; 59.5%). The most common body systems impacted were respiratory (n = 329; 29.6%), skin (n = 164; 16.4%) and general/unspecified (e.g. fever; n = 164; 16.4%). Community-based after-hours services reported different types of presentations, with medical deputising services reporting more urgent presentations, GPs reporting more procedural presentations and walk-in clinics reporting more skin-related issues (e.g. wound care). Community-based after-hours medical services contribute significantly to after-hours medical care in the ACT. Patients are self-selecting community-based after-hours medical services appropriately based on problems managed by practitioners.

摘要

本研究描述了在非工作时间,向社区基层医疗服务机构就诊的患者特征和就诊情况。2019 年,在一个工作日晚上和周末,31 个延长服务时间的全科医生(GP)诊所、3 个医疗代理服务和 3 个护士主导的随到随诊诊所(WIC)中,由从业者自愿进行了一项横断面调查。在 3371 例社区夜间就诊中,获得了 934 份就诊记录(总体应答率:28%)。在研究期间,急诊部门报告了 524 例分诊代码为 4 和 5 的患者。在社区夜间服务中管理的问题大多被评为非紧急(n = 482;51.6%)和新出现的(n = 606;64.9%)。最常见的社区夜间就诊是与诊断或疾病相关的(例如感染或损伤;n = 667;59.5%)。受影响最常见的身体系统是呼吸系统(n = 329;29.6%)、皮肤(n = 164;16.4%)和一般/未特指(例如发热;n = 164;16.4%)。社区夜间服务报告了不同类型的就诊情况,医疗代理服务报告了更紧急的就诊情况,全科医生报告了更多的程序相关就诊情况,随到随诊诊所报告了更多与皮肤相关的问题(例如伤口护理)。社区夜间医疗服务在 ACT 地区的夜间医疗服务中发挥了重要作用。患者根据医生管理的问题,自行选择适合的社区夜间医疗服务。

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