Department of Medicine, University of Chicago, Chicago, IL, USA.
Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Gen Intern Med. 2023 Jan;38(1):147-155. doi: 10.1007/s11606-022-07707-x. Epub 2022 Jul 1.
Many patients do not receive guideline-recommended preventive, chronic disease, and acute care. One potential explanation is insufficient time for primary care providers (PCPs) to provide care.
To quantify the time needed to provide 2020 preventive care, chronic disease care, and acute care for a nationally representative adult patient panel by a PCP alone, and by a PCP as part of a team-based care model.
Simulation study applying preventive and chronic disease care guidelines to hypothetical patient panels.
Hypothetical panels of 2500 patients, representative of the adult US population based on the 2017-2018 National Health and Nutrition Examination Survey.
The mean time required for a PCP to provide guideline-recommended preventive, chronic disease and acute care to the hypothetical patient panels. Estimates were also calculated for visit documentation time and electronic inbox management time. Times were re-estimated in the setting of team-based care.
PCPs were estimated to require 26.7 h/day, comprising of 14.1 h/day for preventive care, 7.2 h/day for chronic disease care, 2.2 h/day for acute care, and 3.2 h/day for documentation and inbox management. With team-based care, PCPs were estimated to require 9.3 h per day (2.0 h/day for preventive care and 3.6 h/day for chronic disease care, 1.1 h/day for acute care, and 2.6 h/day for documentation and inbox management).
PCPs do not have enough time to provide the guideline-recommended primary care. With team-based care the time requirements would decrease by over half, but still be excessive.
许多患者未接受指南推荐的预防、慢性疾病和急性护理。一个潜在的解释是初级保健提供者（PCP）提供护理的时间不足。
通过单独由 PCP 以及通过基于团队的护理模式由 PCP 为代表的成年患者小组，量化提供 2020 年预防保健、慢性疾病护理和急性护理所需的时间。
将预防和慢性疾病护理指南应用于假设患者小组的模拟研究。
基于 2017-2018 年全国健康和营养检查调查的美国成年人口，假设的 2500 名患者小组具有代表性。
PCP 为假设患者小组提供指南推荐的预防、慢性疾病和急性护理所需的平均时间。还计算了就诊记录时间和电子收件箱管理时间的估计值。在基于团队的护理环境中重新估算了时间。
PCP 估计每天需要 26.7 小时，其中 14.1 小时用于预防保健，7.2 小时用于慢性疾病护理，2.2 小时用于急性护理，3.2 小时用于记录和收件箱管理。通过基于团队的护理，PCP 每天估计需要 9.3 小时（2.0 小时用于预防保健和 3.6 小时用于慢性疾病护理，1.1 小时用于急性护理，2.6 小时用于记录和收件箱管理）。
PCP 没有足够的时间提供指南推荐的初级保健。通过基于团队的护理，时间要求将减少一半以上，但仍过高。
