Tilyard M W, Dovey S M, Spears G F
Department of General Practice, Otago Medical School, Dunedin.
N Z Med J. 1995 Apr 12;108(997):118-21.
This study aimed to determine whether conclusions drawn in studies using data from the computer research group of the Royal New Zealand College of General Practitioners (RNZCGP) could be extrapolated to other New Zealand general practices.
Retrospectively collected data on doctor, practice, and consultation variables form the study database. The control group comprised a random sample of 106 New Zealand general practitioners. The study group were 67 general practitioners participating in the RNZCGP computer research group. Comparisons between groups were based on doctor and practice variables, patient demography and morbidity, and number and type of service items observed.
Study group doctors were more likely to have received post graduate training in general practice (p < 0.01) and saw more patients entitled to government subsidised health care (p < 0.01). The geographical distribution of the study group was skewed with more located in the south of New Zealand. Wide variability on most other study parameters was seen among doctors in both groups although overall patient morbidity was similar for both groups in the 8612 consultations analysed. Computer research group general practitioners reported lower rates of patient referral and laboratory investigations, and higher immunisation rates than the control group (p < 0.01).
Although the profile of study group general practitioners was different from that of the control group, data collected by both groups provided a similar reflection of the morbidity and services of New Zealand general practice. Adjustments will be needed for extrapolating the results of research from the RNZCGP computer research group where the focus of the investigation is referrals from primary care, investigations, or immunisations.
本研究旨在确定使用新西兰皇家全科医生学院（RNZCGP）计算机研究组数据的研究所得出的结论是否能外推至新西兰的其他全科医疗诊所。
从研究数据库中回顾性收集关于医生、诊所和诊疗变量的数据。对照组由106名新西兰全科医生的随机样本组成。研究组为67名参与RNZCGP计算机研究组的全科医生。组间比较基于医生和诊所变量、患者人口统计学和发病率，以及观察到的服务项目数量和类型。
研究组医生更有可能接受过全科医疗的研究生培训（p < 0.01），且诊治的享有政府补贴医疗保健资格的患者更多（p < 0.01）。研究组的地理分布不均衡，更多位于新西兰南部。两组医生在大多数其他研究参数上存在很大差异，不过在分析的8612次诊疗中，两组患者的总体发病率相似。计算机研究组的全科医生报告的患者转诊率和实验室检查率低于对照组，而免疫接种率高于对照组（p < 0.01）。
尽管研究组全科医生的概况与对照组不同，但两组收集的数据对新西兰全科医疗的发病率和服务情况给出了相似的反映。对于将RNZCGP计算机研究组的研究结果进行外推时，若研究重点是初级保健转诊、检查或免疫接种，则需要进行调整。
