Hartley R M, Charlton J R, Harris C M, Jarman B
Am J Public Health. 1987 May;77(5):565-7. doi: 10.2105/ajph.77.5.565.
We studied British general practitioners' use of ambulatory resources to determine whether the quantities of different resources used were related to each other, and whether these quantities were associated with their personal characteristics. Rates of laboratory requests, referrals for specialty opinion, prescriptions, and visits per patient per year were examined for 21 physicians in seven practices over one year. Physicians who more frequently saw their patients referred and prescribed for them more often and ordered more tests, once the number of years they had practiced was taken into account. Doctors who ordered more tests referred their patients more frequently, regardless of how often they saw them. Doctors longer in practice saw and prescribed for their patients more frequently. Resource use was not related to other personal characteristics we studied. Greater frequency of patient-physician contact appears to increase costs not only through use of more professional time but also through greater use of other ambulatory resources. Attention to the use of only one type of resource may result in a distorted picture of how physicians care for their patients and the costs that such care incurs.
我们研究了英国全科医生对门诊资源的使用情况，以确定不同资源的使用量是否相互关联，以及这些使用量是否与他们的个人特征有关。在一年的时间里，对7家诊所的21名医生进行了调查，考察了每位患者每年的实验室检查申请率、专科会诊转诊率、处方率和就诊率。一旦考虑到医生的执业年限，那些更频繁看诊患者的医生会更频繁地为患者转诊和开处方，也会安排更多的检查。无论看诊频率如何，安排更多检查的医生会更频繁地为患者转诊。执业时间更长的医生看诊和开处方的频率更高。资源使用与我们研究的其他个人特征无关。医患接触频率的增加似乎不仅会因使用更多专业时间而增加成本，还会因更多地使用其他门诊资源而增加成本。仅关注一种资源的使用情况可能会导致对医生如何照顾患者以及这种护理所产生的成本形成扭曲的认识。
