Chiasson P M, Roy P D
Dickson Centre, Victoria General Hospital, Halifax NS.
CMAJ. 1995 Nov 15;153(10):1447-52.
To determine the present role of general practitioners (GPs) in the delivery of surgical and anesthesia services in rural western Canada.
Survey by mailed questionnaire in November 1993, with telephone follow-up of nonresponders.
Rural British Columbia, Alberta, the Yukon Territory and the Northwest Territories.
Administrators of 148 rural hospitals; of the 121 who completed it 101 represented hospitals that met the inclusion criteria (fewer than 51 beds and serving a population of 15,000 or less).
Hospital characteristics, type of practitioners providing surgical and anesthesia services, length and location of GPs', surgical and anesthesia training, types of surgical procedures performed by GPs and opinions of administrators regarding the delivery of surgical services in their community.
Surgical services were provided by 56 (55%) of the 101 hospitals; at 45 (80%) they were provided by GPs, and at 33 (59%) they were provided by GPs with limited additional surgical training. Fifteen (27%) of the 56 hospitals were said to rely solely on GPs with limited surgical training for surgical services. At 45 (80%) of the 56 hospitals anesthesia services were provided by GPs, all of whom had limited additional training in anesthesia; 36 (64%) were said to rely solely on GPs for anesthesia services. Just over three quarters (76% [74/98]) of the administrators felt that their community's surgical needs were well met.
GPs with limited specialty training continue to play a role in providing surgical and anesthesia services in rural western Canada. This has implications for postgraduate training programs in Canada.
确定加拿大西部农村地区全科医生(GP)在提供外科和麻醉服务方面的当前作用。
1993年11月通过邮寄问卷进行调查,对未回复者进行电话随访。
不列颠哥伦比亚省农村地区、艾伯塔省、育空地区和西北地区。
148家农村医院的管理人员;121名完成问卷的人员中,101名代表符合纳入标准的医院(床位少于51张且服务人口为15000人或更少)。
医院特征、提供外科和麻醉服务的从业者类型、全科医生的外科和麻醉培训时长及地点、全科医生实施的外科手术类型以及管理人员对其所在社区外科服务提供情况的看法。
101家医院中的56家(55%)提供外科服务;其中45家(80%)由全科医生提供,33家(59%)由接受过有限额外外科培训的全科医生提供。56家医院中有15家(27%)据说仅依靠接受过有限外科培训的全科医生提供外科服务。56家医院中有45家(80%)的麻醉服务由全科医生提供,他们都只接受过有限的额外麻醉培训;36家(64%)据说仅依靠全科医生提供麻醉服务。略超过四分之三(76%[74/98])的管理人员认为其所在社区的外科需求得到了很好的满足。
接受有限专科培训的全科医生在加拿大西部农村地区提供外科和麻醉服务方面继续发挥作用。这对加拿大的研究生培训项目有影响。