Chambers R, Belcher J
Centre for Primary Health Care, University of Keele.
Br J Gen Pract. 1993 Oct;43(375):410-2.
A questionnaire survey was undertaken to examine the work patterns of general practitioners before and after the introduction of the 1990 contract. A total of 408 and 697 general practitioners responded to the questionnaire in 1989 and 1991, respectively (response rates of 47% and 82%). In 1991 general practitioners reported spending significantly more evenings on paperwork than in 1989 and significantly more reported being exhausted or stressed at the end of five or more working days. General practitioners were significantly less likely to work four or more sessions per week outside the practice in 1991 than in 1989. There was no difference between 1989 and 1991 in the number of surgeries carried out per week or the number of nights spent on call in a month. In 1991 there was no correlation between the Jarman index allocated to a practice principal and the numbers of surgeries per week, sessions worked outside the practice per week, nights on call per month, weekdays exhausted or stressed, or evenings each week spent on paperwork. Older doctors in 1991 were significantly more likely to work 12 or more nights on call per month, to spend more time doing paperwork in the evenings and more likely to report exhaustion than younger doctors. Women doctors in 1991 were significantly more likely to report doing 10 or more surgeries per week than their men colleagues. It has become more common for general practitioners to complete paperwork at home and report exhaustion or stress since the introduction of the 1990 contract.
开展了一项问卷调查，以研究1990年合同引入前后全科医生的工作模式。1989年和1991年分别有408名和697名全科医生回复了问卷（回复率分别为47%和82%）。1991年，全科医生报告称，与1989年相比，花在文书工作上的晚上显著增多，而且更多人报告在五个或更多工作日结束时感到疲惫或压力大。1991年，全科医生在诊所外每周工作四个或更多时段的可能性比1989年显著降低。1989年和1991年每周进行的诊疗次数或每月值班的夜间次数没有差异。1991年，分配给诊所负责人的贾曼指数与每周的诊疗次数、每周在诊所外工作的时段数、每月值班的夜间数、工作日感到疲惫或压力大的天数，或每周花在文书工作上的晚上数之间没有相关性。1991年，年长的医生每月值班12个或更多夜间的可能性显著高于年轻医生，晚上花在文书工作上的时间更多，而且更有可能报告疲惫。1991年，女医生报告每周进行10次或更多诊疗的可能性显著高于男同事。自1990年合同引入以来，全科医生在家完成文书工作并报告疲惫或压力大的情况变得更加普遍。
