Steven I D, Dickens E, Thomas S A, Browning C, Eckerman E
Royal Australian College of General Practitioners.
Aust Fam Physician. 1998 Jan;27 Suppl 1:S44-6.
To explore whether there are associations between continuity of care and the provision of items of preventive care in Australian general practice.
Patient completed questionnaires from a 'consecutive' sample of Australian general practitioners enrolled in the Patient Participation Program of the Quality Assurance and Continuing Medical Education Program of the Royal Australian College of General Practitioners.
An association was sought between the length of time patients reported attending their practitioner, whether they regularly attended more than one practice, and whether they were provided with preventive care.
Data from 12,605 questionnaires, completed by patients from 133 practices throughout Australia found that patients who reported only visiting one practice on a regular basis were significantly more likely to report the provision of: blood pressure screening within the past 12 months; cholesterol screening in the past 5 years; adequate smoking cessation information if required; to have discussed the benefits of diet and exercise; to have received a cervical smear in the past 2 years; and to have received adequate instruction in the technique of breast self examination. Patients attending the same practices for longer periods were significantly more likely to have received the above items with the exception of adequate information to enable them to stop smoking if they desired; and cervical smears in the past 2 years. Such patients were less likely to report the provision of tetanus immunisation in the past 10 years and cervical smears in the past 2 years.
Patients reporting greater continuity of care measured by only consulting at one practice or visiting the practice for a longer time period reported a greater provision of preventive care than patients who did not report these characteristics.
探讨在澳大利亚全科医疗中,医疗连续性与预防性医疗项目的提供之间是否存在关联。
对参加澳大利亚皇家全科医师学院质量保证与继续医学教育项目患者参与计划的澳大利亚全科医生的“连续”样本中的患者填写的问卷进行分析。
研究患者报告就诊时间长短、是否经常在多家诊所就诊与是否接受预防性医疗之间的关联。
来自澳大利亚各地133家诊所的患者填写的12,605份问卷数据显示,报告仅定期在一家诊所就诊的患者更有可能报告在过去12个月内接受过血压筛查;在过去5年内接受过胆固醇筛查;在需要时获得了足够的戒烟信息;讨论过饮食和运动的益处;在过去2年内接受过宫颈涂片检查;以及接受过乳房自我检查技术的充分指导。在同一诊所就诊时间较长的患者更有可能接受上述项目,但如果他们想戒烟,获得足够信息这一项除外;以及在过去2年内接受宫颈涂片检查。这类患者不太可能报告在过去10年内接受过破伤风免疫接种以及在过去2年内接受过宫颈涂片检查。
与未报告这些特征的患者相比,报告医疗连续性更好的患者(通过仅在一家诊所就诊或在诊所就诊时间更长来衡量)报告接受的预防性医疗更多。