哮喘患者的综合护理：全科医生的观点

Integrated care for patients with asthma: views of general practitioners.

作者信息

Van Damme R, Drummond N, Beattie J, Douglas G

机构信息

Katholieke Universiteit, Nijmegen, Netherlands.

出版信息

Br J Gen Pract. 1994 Jan;44(378):9-13.

PMID:8312046

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1238755/

Abstract

BACKGROUND

In 1989, a shared or integrated care scheme was developed for hospital outpatients with asthma, using the computerized patient record system of Grampian Health Board, Scotland. Patients with asthma attending hospital clinics were entered into this scheme and were invited to attend their general practitioner instead of an outpatient clinic for review of their asthma. Three-monthly questionnaires covering clinical aspects of asthma were sent to these patients and their general practitioners; the latter then returned them to the specialist. Patients could be recalled to the hospital clinic if either the general practitioner or consultant felt this was necessary and all patients were reviewed after one year by the specialist. The success of integrated care for patients with asthma relies on the cooperation of general practitioners.

AIM

The aim of this study was to investigate how this scheme worked in general practice, and general practitioners' perceptions of it, in order to identify factors that enhance or inhibit integrated care for patients with asthma in general practice.

METHOD

A qualitative survey was carried out with a random, stratified sample of 38 of the 317 general practitioners in the region. Semi-structured interviews were designed to elicit general practitioners' accounts of their operation of integrated care and their attitudes towards the scheme.

RESULTS

General practitioners perceived the scheme to have several advantages: the continuity and quality of care provided was improved; and the transmission of information between general practitioner and specialist was enhanced. Regular general practitioner reviews, instigated by standard letters generated by computer, were favoured as being clearly structured. Concerns were raised about the processing of paperwork, and the possibility that unnecessary reviews might be generated.

CONCLUSION

Integrated care for asthma patients is an acceptable management option among general practitioners.

摘要

背景

1989年，利用苏格兰格兰扁健康委员会的计算机化患者记录系统，为医院哮喘门诊患者制定了一项共享或综合护理计划。在医院诊所就诊的哮喘患者被纳入该计划，并被邀请去看他们的全科医生，而不是去门诊复查哮喘。每三个月会向这些患者及其全科医生发送涵盖哮喘临床方面的问卷；然后后者将问卷返还给专科医生。如果全科医生或顾问认为有必要，患者可以被召回医院诊所，并且所有患者在一年后由专科医生进行复查。哮喘患者综合护理的成功依赖于全科医生的合作。