Campbell J L
Department of General Practice, United Medical and Dental Schools of Guys and St. Thomas's Hospitals, London.
Br J Gen Pract. 1996 Aug;46(409):465-8.
Combined practice list sizes have increased, but larger practice size may be associated with disadvantage to patients.
The aim of the study was to investigate the availability of general practitioners as reported by their patients and the relationship between reported availability and practice list size.
A one-week questionnaire survey of 8315 patients attending participating practices in West Lothian, Scotland, was conducted. Patients were asked about the arrangements for being seen at that attendance, their perception of doctor availability following an urgent or non-urgent consultation request, and their social and demographic characteristics. The proportion of respondents reporting they could see a doctor the same day following an urgent consultation request or within 2 days following a non-urgent consultation request was determined for each practice.
Eighteen out of 26 practices agreed to participate in the study, and an overall response rate of 61% was obtained in the patient survey. Participating practices were representative of all practices in the area with regard to list size; questionnaire respondents were representative of the age profile of participating practices and were representative of the local general population with regard to car and home ownership. There was a wide variation among practices in the proportion of questionnaire respondents who reported that a doctor was available within 2 days following a non-urgent consultation request [mean 60.7 (SE 7.1%)], but less variation for the reported availability on the same day after an urgent consultation request [mean 81.1 (SE 2.3 %)]. A significant negative association was demonstrated between combined practice list size and reported non-urgent or urgent availability.
Wide variation exists between practices with regard to patients' perceptions of doctor availability, and smaller practices may have advantages in this regard. The feelings and perceptions of patients should be taken into account when planning or reviewing the delivery of primary health care.
联合执业名单规模有所增加，但规模较大的执业可能对患者不利。
本研究旨在调查患者报告的全科医生可就诊情况，以及报告的可就诊情况与执业名单规模之间的关系。
对苏格兰西洛锡安参与调查的执业机构中的8315名患者进行了为期一周的问卷调查。询问患者此次就诊的预约安排、他们对紧急或非紧急咨询请求后医生可就诊情况的看法以及他们的社会和人口统计学特征。确定每个执业机构中报告在紧急咨询请求后当天或非紧急咨询请求后2天内能够看医生的受访者比例。
26个执业机构中有18个同意参与研究，患者调查的总体回复率为61%。参与调查的执业机构在名单规模方面代表了该地区所有执业机构；问卷受访者代表了参与调查执业机构的年龄分布，在汽车和房屋拥有情况方面代表了当地普通人群。在报告非紧急咨询请求后2天内有医生可就诊的问卷受访者比例方面，各执业机构之间存在很大差异[均值60.7（标准误7.1%）]，但在紧急咨询请求后当天报告的可就诊情况方面差异较小[均值81.1（标准误2.3%）]。联合执业名单规模与报告的非紧急或紧急可就诊情况之间存在显著的负相关。
各执业机构在患者对医生可就诊情况的看法上存在很大差异，规模较小的执业机构在这方面可能具有优势。在规划或审查初级卫生保健服务时，应考虑患者的感受和看法。
