Postgraduate and Continuing Education in Health Sciences, Faculty of Life Sciences,, Universidad Nebrija, Madrid, Spain.
Continuing Medical Education Centre of the Official Medical College of Barcelona, Barcelona, Spain.
BMC Med Educ. 2024 Jul 14;24(1):758. doi: 10.1186/s12909-024-05748-w.
Frequent attendance is a common issue for primary care health centres. The phenomenon affects the quality of care, increases doctors' workloads and can lead to burnout.This study presents the results of an educational intervention for primary care physicians, aimed at helping them to decrease the prevalence rate of excessive attendance by patients at their centres.
A training programme was carried out for 11 primary care doctors in Barcelona who had patient lists totalling 20,064 patients. The goal of the training was to provide the participating physicians with techniques to curb frequent attendance. Additionally, the programme sought to offer them strategies to prevent professional burnout and tools to better organize their everyday medical practice. The study used a quasi-experimental design for an evaluation of an educational intervention, featuring a pre-test assessment (before the training programme) and a post-test assessment (after the training programme), as well as comparison with a control group that did not undergo the training. The study assessed the effects of the programme on the rates of frequent attendance of patients served by the participating physicians. These rates were compared with those registered by the patients seen by the control group physicians over the same period.
Among the group of physicians who received the training, the mean prevalence of patients who qualified as frequent attenders decreased from 22% prior to the training programme to 8% after completion of the programme. In other words, 14% of patients (2,809) limited the frequency of their visits to primary care physicians after their physicians had completed the training programme. Meanwhile, the study recorded an average decrease of 3.1 visits per year by the patients of the physicians who had undergone the training. Statistically significant differences between this group and the control group were observed.
The educational intervention proved effective at helping primary care physicians to decrease their patients' rates of frequent attendance. It also contributes to the impact research of continuing education on doctors and their patients. We need to increase primary care spending from the current 14% to the 25%, to address this problem, among others.
频繁就诊是基层医疗保健中心的一个常见问题。这种现象会影响医疗质量，增加医生的工作量，并导致倦怠。本研究介绍了一项针对基层医疗保健医生的教育干预措施的结果，旨在帮助他们降低患者在中心过度就诊的发生率。
在巴塞罗那，对 11 名拥有 20064 名患者的初级保健医生进行了培训计划。培训的目的是为参与培训的医生提供控制频繁就诊的技术。此外，该计划还为他们提供了预防职业倦怠的策略以及更好地组织日常医疗实践的工具。该研究采用准实验设计评估教育干预措施，包括前测评估（培训计划之前）和后测评估（培训计划之后），并与未接受培训的对照组进行比较。研究评估了该计划对参与医生服务的患者频繁就诊率的影响。将这些比率与同期对照组医生就诊的患者记录的比率进行比较。
在接受培训的医生组中，符合频繁就诊者标准的患者的平均患病率从培训计划前的 22%下降到培训计划完成后的 8%。换句话说，在医生完成培训计划后，有 14%的患者（2809 人）限制了他们到基层保健医生处就诊的频率。同时，研究记录了接受培训的医生的患者每年平均就诊次数减少了 3.1 次。在该组与对照组之间观察到了统计学上的显著差异。
教育干预措施被证明有助于基层医疗保健医生降低患者的频繁就诊率。它还为继续教育对医生及其患者的影响研究做出了贡献。除其他问题外，我们需要将目前占 14%的基层医疗保健支出增加到 25%，以解决这个问题。
