Wilkieson C A, Campbell A M, McWhirter M F, McIntosh I B, McAlpine C H
Stirling Royal Infirmary NHS Health Trust, Stirling.
Br J Gen Pract. 1996 May;46(406):307-8.
The new contract for general practitioners (GPs) was introduced in 1990. This required all GPs to offer their patients aged 75 years of over an annual assessment.
The study aimed to determine if 3 years' experience had resulted in standardization of the way in which health assessments for patients aged 75 years and over are carried out.
The study was carried out in 1993. Questionnaires were sent to the principal partners of all 55 general practices in the Forth Valley Health Board (FVHB) area. The main outcome measures were the fulfilment of contractual requirements and standardization of the health assessment process.
Completed questionnaires were returned by 49 practices (89%) Eighty per cent (39 practices) had drawn up their own assessment programme in 1990. Responsibility for assessments was most often (41 practices) shared between different members of the primary care team (84%). Although most practices satisfied contractual requirements, there were wide variations in approach, potentially influencing outcome.
Despite three years' experience, no standardized approach to the health assessment of patients aged 75 years and over has been developed. Purchasers of health care require information on the needs of their client population, and this should be available in an accessible, standardized form. There is an urgent need for a review of the way in which the 1990 contract has been implemented to standardize health assessments and improve effectiveness in meeting its original aims.
1990年引入了全科医生新合同。这要求所有全科医生为75岁及以上的患者提供年度评估。
该研究旨在确定3年的经验是否使75岁及以上患者健康评估的方式实现了标准化。
该研究于1993年进行。向福斯谷健康委员会（FVHB）地区所有55家全科诊所的主要合伙人发送了问卷。主要结果指标是合同要求的履行情况和健康评估过程的标准化。
49家诊所（89%）返回了完整的问卷。80%（39家诊所）在1990年制定了自己的评估方案。评估责任最常由初级保健团队的不同成员分担（41家诊所，占84%）。虽然大多数诊所满足了合同要求，但方法存在很大差异，这可能会影响结果。
尽管有3年的经验，但尚未形成针对75岁及以上患者健康评估的标准化方法。医疗保健购买者需要有关其客户群体需求的信息，并且应以易于获取的标准化形式提供这些信息。迫切需要对1990年合同的实施方式进行审查，以实现健康评估的标准化并提高实现其最初目标的有效性。
