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优化个人连续性:全科医生与老年患者观点调查

Optimising personal continuity: a survey of GPs' and older patients' views.

作者信息

Groot Lex, Te Winkel Marije, Schers Henk, Burgers Jako, Smalbrugge Martin, Uijen Annemarie, van der Horst Henriëtte, Maarsingh Otto

机构信息

Department of General Practice, Amsterdam UMC, Vrije Universiteit Amsterdam, Aging and Later Life, Amsterdam Public Health, Amsterdam, The Netherlands.

Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

出版信息

BJGP Open. 2023 Jun 27;7(2). doi: 10.3399/BJGPO.2022.0099. Print 2023 Jun.

Abstract

BACKGROUND

Personal continuity - having a GP who knows their patients and keeps track of them - is an important dimension of continuity of care and is associated with lower mortality rates, higher quality of life, and reduced healthcare costs. In recent decades it has become more challenging for GPs to provide personal continuity owing to changes in society and health care.

AIM

To investigate GPs' and older patients' views on personal continuity and how personal continuity can be improved.

DESIGN & SETTING: Cross sectional survey study in The Netherlands.

METHOD

A digital and postal survey was sent to 499 GPs and 1599 patients aged 65 years or older. Results were analysed using descriptive statistics for quantitative data and thematic analysis for open questions.

RESULTS

In total, 249 GPs and 582 patients completed the surveys. A large majority of GPs (92-99%) and patients (91-98%) felt it was important for patients to see their own GP for life events or psychosocial issues. GPs and patients provided suggestions on how personal continuity can be improved. The thematic analysis of these suggestions identified nine themes: 1) personal connection, 2) GP accessibility and availability, 3) communication about (dis)continuity, 4) GP responsibility, 5) triage, 6) time for the patient, 7) actions by third parties, 8) team continuity, and 9) GP vocational training.

CONCLUSION

Both GPs and older patients still place high value on personal continuity in the context of a changing society. GPs and patients provided a wide range of suggestions for improving personal continuity. The authors will use these suggestions to develop interventions for optimising personal continuity in general practice.

摘要

背景

个人连续性——拥有了解患者并跟踪其情况的全科医生——是连续性医疗的一个重要方面,与较低的死亡率、较高的生活质量和降低的医疗成本相关。近几十年来,由于社会和医疗保健的变化,全科医生提供个人连续性服务变得更具挑战性。

目的

调查全科医生和老年患者对个人连续性的看法以及如何改善个人连续性。

设计与设置

荷兰的横断面调查研究。

方法

向499名全科医生和1599名65岁及以上的患者发送了数字和邮寄调查问卷。使用定量数据的描述性统计和开放性问题的主题分析对结果进行分析。

结果

共有249名全科医生和582名患者完成了调查。绝大多数全科医生(92 - 99%)和患者(91 - 98%)认为患者在遇到生活事件或心理社会问题时看自己的全科医生很重要。全科医生和患者就如何改善个人连续性提出了建议。对这些建议的主题分析确定了九个主题:1)个人联系,2)全科医生的可及性和可用性,3)关于(不)连续性的沟通,4)全科医生的责任,5)分诊,6)为患者留出时间,7)第三方的行动,8)团队连续性,9)全科医生职业培训。

结论

在社会不断变化的背景下,全科医生和老年患者仍然高度重视个人连续性。全科医生和患者为改善个人连续性提供了广泛的建议。作者将利用这些建议制定干预措施,以优化全科医疗中的个人连续性。

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