Rennes University, Centre Hospitalier Universitaire (CHU) de Rennes, Department of General Practice, Rennes, France.
Rennes University, Centre Hospitalier Universitaire (CHU) de Rennes, Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-1414, Rennes, France.
NPJ Prim Care Respir Med. 2023 Sep 30;33(1):33. doi: 10.1038/s41533-023-00352-9.
In France, most spirometries are performed by pneumologists. Spirometry is difficult to access due to the distance to medical office and long delays for appointments. This lack of accessibility contributes to the underdiagnosis of chronic obstructive pulmonary disease (COPD) among patients aged between 40 and 75 years. In recent years, general practitioners (GPs) have been performing spirometry in private practice. However, the extent of this practice is unknown. A French retrospective, repetitive transversal study analysed data from the "Système National des Données de Santé" (SNDS) database. The targeted population was GPs in primary care that performed spirometries between 2010 and 2018, in patients aged between 40 and 75 years. Between 2010 and 2018, 302,674 (7.2%) spirometries were performed in France by GPs in private practices, in patients 40 to 75 years old. 5.4% by "expert GPs" (>60 spirometries/year) and 1.8% by "non-expert GPs". In "non-expert GPs" (2.8% of French GPs in 2018), the annual number of spirometries increased by 701 each year (p < 2.10), the annual number of GPs performing spirometries increased by 114 each year (p < 2.10). Overall, 24.9% of the spirometries performed by GPs were referrals from other GPs. The number of spirometries performed by GPs and the number of GPs performing spirometries has gradually increased over time. However, this increase is inadequate considering the need to early detect and follow up respiratory disorders.
在法国，大多数肺量计检查都是由肺科医生进行的。由于距离医疗办公室较远以及预约时间较长，肺量计检查难以获得。这种可及性不足导致 40 至 75 岁之间的患者慢性阻塞性肺疾病（COPD）的诊断不足。近年来，全科医生（GP）一直在私人诊所进行肺量计检查。然而，这种做法的程度尚不清楚。一项法国回顾性、重复性横断面研究分析了来自“国家健康数据系统”（SNDS）数据库的数据。目标人群是在 2010 年至 2018 年期间在初级保健中为 40 至 75 岁患者进行肺量计检查的全科医生。2010 年至 2018 年期间，法国私人执业的全科医生共为 40 至 75 岁的患者进行了 302674 次肺量计检查（7.2%）。其中 5.4%由“专家 GP”（每年进行超过 60 次肺量计检查）进行，1.8%由“非专家 GP”进行。在“非专家 GP”（2018 年法国全科医生的 2.8%）中，每年进行的肺量计检查数量每年增加 701 次（p < 2.10），每年进行肺量计检查的 GP 数量每年增加 114 次（p < 2.10）。总体而言，GP 进行的肺量计检查中有 24.9%是由其他 GP 转诊而来。GP 进行的肺量计检查数量和进行肺量计检查的 GP 数量随着时间的推移逐渐增加。然而，考虑到早期发现和跟踪呼吸障碍的需要，这种增加是不够的。
