Cullen R
N Z Med J. 1994 Apr 27;107(976):152-3.
In a multidoctor family practice there are often just too many sets of patients records to make it practical to repeat an audit by census of even an age band of the practice on a regular basis. This paper attempts to demonstrate how sample survey methodology can be incorporated into the quality assurance cycle.
A simple random sample (with replacement) of 120 from 580 children with permanent records who were aged between 6 weeks and 2 years old from an Auckland general practice was performed, with sample size selected to give a predetermined precision. The survey was then repeated after 4 weeks.
Both surveys were able to be completed within the course of a normal working day. An unexpectedly low level of under 2 years olds that were recorded as not overdue for any immunisations was found (22.5%) with only a modest improvement after a standard telephone/letter catch up campaign. Seventy-two percent of the sample held a group one community services card.
The advantages of properly conducted sample surveys in producing useful estimates of known precision without disrupting office routines excessively were demonstrated. Through some attention to methodology, the trauma of a practice census can be avoided.
在多医生家庭诊所中,患者记录往往过多,以至于定期对诊所内某个年龄段的患者进行普查式的重复审核变得不切实际。本文试图说明如何将抽样调查方法纳入质量保证周期。
从奥克兰一家全科诊所的580名有永久记录、年龄在6周龄至2岁之间的儿童中,进行了一次简单随机抽样(可重复抽样),抽取120名样本,样本量的选择是为了达到预定的精度。4周后重复进行该调查。
两项调查均能在正常工作日内完成。发现记录为未逾期接种任何疫苗的2岁以下儿童比例出乎意料地低(22.5%),在开展标准的电话/信件跟进活动后,仅有适度改善。样本中有72%持有一级社区服务卡。
证明了正确开展抽样调查在产生具有已知精度的有用估计值且不过度扰乱日常工作方面的优势。通过对方法给予一定关注,可以避免诊所普查带来的麻烦。