Hallam L, Cragg D
Department of General Practice, University of Manchester, Rusholme Health Centre.
BMJ. 1994 Dec 17;309(6969):1621-3. doi: 10.1136/bmj.309.6969.1621.
To determine the use and organisation of out of hours services in primary care.
Telephone survey.
Family health services authorities in England and Wales.
Rate of use of out of hours care, methods of provision, and role of authorities.
12-25% of authorities were unable to answer one or more key questions in the survey because of insufficient information. The mean number of night visits made per unrestricted principal per 1000 patients per year was 35.3. 13 of the 19 authorities with averages above 40 covered large towns or cities. 81 authorities had at least one commercial deputising service. In 46 metropolitan districts and one other district over 75% of general practitioners had consent to use a deputising service, although not all did so. Information on cooperation between practices was limited. 22 cooperatives were recognised by the authorities, nine were not officially recognised, and a further 13 were nearing institution. Only two cooperatives were in areas with extensive use of deputising services.
Methods of providing out of hours care are changing, and without good information systems family health services authorities will not be able to monitor the effect on quality and cost effectiveness of care.
确定基层医疗中夜间服务的使用情况及组织方式。
电话调查。
英格兰和威尔士的家庭健康服务机构。
夜间护理的使用率、提供方式及机构的作用。
12% - 25%的机构因信息不足无法回答调查中的一个或多个关键问题。每年每1000名患者中每位不受限制的负责人进行的夜间出诊平均次数为35.3次。19个平均次数高于40次的机构中有13个覆盖大城市。81个机构至少有一项商业代理服务。在46个都会区和另一个区，超过75%的全科医生同意使用代理服务，尽管并非所有人都这样做。关于诊所间合作的信息有限。22个合作社得到机构认可，9个未获官方认可，另有13个即将成立。只有两个合作社所在地区广泛使用代理服务。
夜间护理的提供方式正在改变，没有良好的信息系统，家庭健康服务机构将无法监测其对护理质量和成本效益的影响。
