Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland.
Swiss Med Wkly. 2024 Jul 11;154:3643. doi: 10.57187/s.3643.
Due to the increasing complexity of the healthcare system, effective communication and data exchange between hospitalists (in-hospital physicians) and primary care physicians (PCPs) is both central and challenging. In Switzerland, little is known about hospitalists' perception of their communication with PCPs. The primary objective was to assess hospitalists' satisfaction with their communication with PCPs. Secondary objectives addressed all information about the referral process and communication with PCPs during and after the hospital encounter. Lastly, the results of a previous survey among PCPs were juxtaposed to compare their responses to similar questions.
This study surveyed hospitalists in six hospitals in the Central Switzerland region. The survey was sent via email to hospitalists from November 2021 to February 2022. The questionnaire contained 17 questions with single- and multiple-choice answers and the option of free-text entry. Exploratory multivariable logistic regression was used to analyse independent associations.
In total, 276 of 1134 hospitalists responded (response rate 24.3%): (1) the majority of hospitalists are satisfied with the general communication (n = 162, 58.7%) as well as with referral letters (n = 145, 52.5%), (2) preferred information channels for referral letters are email (n = 212, 76.8%) and electronic portals (n = 181, 65.5%), (3) the three most important items of information in referrals are: medication list, diagnoses and reason for referral. In multivariable regression, compared to other clinicians, internists independently favoured informing PCPs of emergency admissions of their patients in a timely manner (OR 2.04; 95%CI 1.21-3.49). Comparing responses from PCPs (n = 109), the most prominent discrepancy was that 67% (n = 184) of hospitalists claimed to "always" inform after an encounter, whereas only 7% (n = 8) of PCPs agreed.
Most hospitalists are satisfied with the communication with PCPs and prefer electronic communication channels. Room for improvement was found around timely transmission of patient information before and after hospital encounters.
由于医疗体系日益复杂，医院医师（住院医师）与基层保健医生（PCP）之间的有效沟通和数据交换至关重要，但也极具挑战性。在瑞士，人们对医院医师对其与 PCP 沟通的看法知之甚少。本研究的主要目的是评估医院医师对其与 PCP 沟通的满意度。次要目标则涵盖了在住院期间和之后与 PCP 沟通时和沟通后的所有转诊流程和沟通信息。最后，将对比之前针对 PCP 进行的一项调查结果，以比较他们对类似问题的回应。
本研究对瑞士中部地区六家医院的医院医师进行了调查。调查于 2021 年 11 月至 2022 年 2 月期间通过电子邮件发送给医院医师。问卷包含 17 个问题，有单项和多项选择以及自由文本输入选项。采用探索性多变量逻辑回归分析独立关联。
共有 1134 名医院医师中的 276 名（回应率 24.3%）：（1）大多数医院医师对一般沟通（n = 162，58.7%）以及转诊信（n = 145，52.5%）感到满意；（2）他们更倾向于通过电子邮件（n = 212，76.8%）和电子门户（n = 181，65.5%）接收转诊信；（3）转诊中最重要的三项信息是：药物清单、诊断和转诊原因。在多变量回归中，与其他临床医生相比，内科医生更倾向于及时向 PCP 告知其患者的紧急入院情况（比值比 2.04；95%置信区间 1.21-3.49）。与 PCP（n = 109）的回应进行对比，最显著的差异是 67%（n = 184）的医院医师声称在每次就诊后“总是”告知，而只有 7%（n = 8）的 PCP 表示同意。
大多数医院医师对与 PCP 的沟通感到满意，并更喜欢电子沟通渠道。在住院前后及时传输患者信息方面仍有改进空间。
