Bertakis K D, Callahan E J, Helms L J, Azari R, Robbins J A
Davis Health Services Research Group, University of California.
Fam Med. 1993 Sep;25(8):530-5.
The recent development of health status measures now facilitates the study of how patient health influences physician practice style.
The health status of 150 new patients at a university primary care center was assessed using the Medical Outcomes Study Short-Form General Health Survey. Videotapes of the physician-patient encounter were analyzed with the Davis Observation Code to explore the effect of patient health status on physician practice style.
Regression analyses demonstrated that better health was predictive of a greater portion of the visit being spent on physical examination and chatting and a smaller portion of the visit on history taking. Counseling was predicted by diminished patient mental health scores. Preliminary evidence was found for different practice styles based on patient characteristics such as sex, age, education, and income.
Results suggest that the physician-patient encounter is strongly influenced by health status. It will be crucial for future studies of physician-patient interaction to include an assessment of the patient's health status.
健康状况测量方法的最新发展现在有助于研究患者健康如何影响医生的执业方式。
使用医学结果研究简式一般健康调查问卷对一所大学初级保健中心的150名新患者的健康状况进行评估。使用戴维斯观察代码对医患会面的录像进行分析，以探讨患者健康状况对医生执业方式的影响。
回归分析表明，健康状况越好，用于体格检查和聊天的就诊时间比例越高，而用于病史采集的就诊时间比例越低。患者心理健康评分降低可预测咨询情况。发现了基于患者特征（如性别、年龄、教育程度和收入）的不同执业方式的初步证据。
结果表明，医患会面受到健康状况的强烈影响。对于未来医患互动的研究而言，纳入对患者健康状况的评估至关重要。
