Department of General Practice/Family Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
Fam Med. 2023 Jan;55(1):27-33. doi: 10.22454/FamMed.55.740827.
Office-based minor surgery (OBMS) refers to all surgical procedures performed under local anesthetic in the office setting. It is cost effective for the health economy, safe, and appreciated by patients. It is not yet fully understood why some general practitioners (GPs) perform OBMS and others do not, while there is a growing demand for OBMS. Therefore, we explored factors that influence the performance of OBMS by GPs. The aim of this study is to explore the facilitators and barriers that influence GPs in deciding whether to perform OBMS.
We performed a qualitative study using focus groups consisting of GPs and GP trainers. Two researchers analyzed the data independently.
The analysis resulted in a comprehensive list of facilitators and barriers. Besides already known factors such as financial consequences and geographic location, the most important factors influencing the decision to perform OBMS were training and the role of the GP trainer; fear of having to work alone and having to solve unexpected complications; and the influence of collaboration, organization, and facilities in the GP's own practice.
The increasing demand for OBMS in primary care centers requires more attention to training aspects, the existing fear, adequate reimbursement for special accreditation, and collaboration and organization. We expect that addressing these factors will result in the strengthening of primary care, improving patient safety, lower referral rates, and a reduction in health care costs.
门诊小手术（OBMS）是指在门诊环境下，在局部麻醉下进行的所有手术操作。它对卫生经济具有成本效益，安全且受到患者的赞赏。目前还不完全清楚为什么有些全科医生（GP）会进行 OBMS，而有些则不进行，而对 OBMS 的需求却在不断增长。因此，我们探讨了影响全科医生进行 OBMS 的因素。本研究旨在探讨影响全科医生决定是否进行 OBMS 的促进因素和障碍因素。
我们采用焦点小组的方法进行了一项定性研究，参与者包括全科医生和全科医生培训师。两名研究人员独立分析数据。
分析结果得出了一系列促进因素和障碍因素。除了已经知道的经济后果和地理位置等因素外，影响决定进行 OBMS 的最重要因素是培训和 GP 培训师的角色；害怕独自工作和不得不解决意外并发症；以及在 GP 自己的实践中合作、组织和设施的影响。
初级保健中心对 OBMS 的需求不断增加，需要更加关注培训方面、现有的恐惧、对特殊认证的充分补偿、以及合作和组织。我们预计，解决这些因素将加强初级保健、提高患者安全性、降低转诊率和降低医疗保健成本。
