Fylkesnes K
Institute of Community Medicine, University of Tromsø, Norway.
Scand J Soc Med. 1993 Mar;21(1):40-50. doi: 10.1177/140349489302100107.
This study explores determinants of I) general practitioner (GP) visits and II) referrals (outpatient and hospitalization). The analyses were performed with regression models on a set of data from a comprehensive population study of 3533 men and 3578 women aged 40-42 in a county in Northern Norway. Among the various health status dimensions included, self-rated health was found to be the most important determinant, regardless of type of service. Factors, other than health status aspects affecting GP visits, were preoccupation with health and help seeking attitude. Volume of resources (GP per population), socio-demographic characteristics and social networks did not appear as important. Several inequitable effects were revealed on referrals: First, higher rate of referral of patients with higher educational achievement indicates a bias towards higher social status groups. Second, high GP/population ratio and residence in municipalities with referral care facilities were both found to be associated with higher probability of referral.
一是全科医生（GP）诊疗，二是转诊（门诊和住院）。分析采用回归模型，基于挪威北部某县对3533名40 - 42岁男性和3578名40 - 42岁女性进行的一项综合人群研究的数据集。在所纳入的各种健康状况维度中，无论服务类型如何，自评健康状况被发现是最重要的决定因素。除健康状况外，影响全科医生诊疗的因素还有对健康的过度关注和求助态度。资源量（每人口的全科医生数量）、社会人口特征和社会网络似乎并非重要因素。研究还揭示了转诊方面的一些不平等效应：第一，教育程度较高的患者转诊率较高，这表明存在偏向社会地位较高群体的偏差。第二，高全科医生/人口比率以及居住在设有转诊护理设施的市镇，均被发现与较高的转诊概率相关。
