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澳大利亚早期职业全科医生提供非工作时间护理的患病率及相关因素

The prevalence and associations of Australian early-career general practitioners' provision of after-hours care.

作者信息

Turnock Allison, Fielding Alison, Moad Dominica, Tapley Amanda, Davey Andrew, Holliday Elizabeth, Ball Jean, Bentley Michael, FitzGerald Kristen, Kirby Catherine, Spike Neil, van Driel Mieke L, Magin Parker

机构信息

University of Tasmania, School of Medicine, Hobart, Tasmania, Australia.

Department of Health, Hobart, Tasmania, Australia.

出版信息

Aust J Rural Health. 2023 Oct;31(5):906-913. doi: 10.1111/ajr.13022. Epub 2023 Jul 24.

Abstract

INTRODUCTION

Access to after-hours care (AHC) is an important aspect of general practice service provision.

OBJECTIVE

To establish the prevalence and associations of early-career GPs' provision of AHC.

DESIGN

An analysis of data from the New alumni Experiences of Training and independent Unsupervised Practice (NEXT-UP) cross-sectional questionnaire-based study. Participants were early-career GPs (6-month to 2-year post-Fellowship) following the completion of GP vocational training in NSW, the ACT, Victoria or Tasmania. The outcome factor was 'current provision of after-hours care'. Associations of the outcome were established using multivariable logistic regression.

FINDINGS

Three hundred and fifty-four early-career GPs participated (response rate 28%). Of these, 322 had responses available for analysis of currently performing AHC. Of these observations, 128 (40%) reported current provision of AHC (55% of rural participants and 32% of urban participants). On multivariable analysis, participants who provided any AHC during training were more likely to be providing AHC (odds ratio (OR) 5.51, [95% confidence interval (CI) 2.80-10.80], p < 0.001). Current rural location and in-training rural experience were strongly associated with currently providing AHC in univariable but not multivariable analysis.

DISCUSSION

Early-career GPs who provided AHC during training, compared with those who did not, were more than five times more likely to provide after-hours care in their first 2 years after gaining Fellowship, suggesting participation in AHC during training may have a role in preparing registrars to provide AHC as independent practitioners.

CONCLUSION

These findings may inform future GP vocational training policy and practice concerning registrars' provision of AHC during training.

摘要

引言

提供非工作时间护理(AHC)是全科医疗服务的一个重要方面。

目的

确定初入职场的全科医生提供AHC的患病率及相关因素。

设计

对新校友培训与独立无监督实践经历(NEXT-UP)基于横断面问卷调查研究的数据进行分析。参与者为在新南威尔士州、澳大利亚首都直辖区、维多利亚州或塔斯马尼亚州完成全科医生职业培训后的初入职场的全科医生(获得 Fellowship 后6个月至2年)。结果因素为“当前提供非工作时间护理”。使用多变量逻辑回归确定结果的相关因素。

结果

354名初入职场的全科医生参与(回复率28%)。其中,322人的回复可用于分析当前是否提供AHC。在这些观察对象中,128人(40%)报告当前提供AHC(农村参与者的比例为55%,城市参与者为32%)。多变量分析显示,在培训期间提供过任何AHC的参与者更有可能当前仍在提供AHC(比值比(OR)5.51,[95%置信区间(CI)2.80 - 10.80],p < 0.001)。在单变量分析中,当前位于农村地区以及培训期间有农村工作经历与当前提供AHC密切相关,但在多变量分析中并非如此。

讨论

在培训期间提供AHC的初入职场的全科医生,与未提供的相比,在获得 Fellowship 后的头两年提供非工作时间护理的可能性高出五倍多,这表明培训期间参与AHC可能有助于培训生为作为独立从业者提供AHC做好准备。

结论

这些发现可能为未来关于培训生在培训期间提供AHC的全科医生职业培训政策和实践提供参考。

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