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背景在英国,基层医疗中非工作时间的电话分诊大多由护士负责,而在丹麦则由全科医生负责。目的描述从全科医生的电话分诊到面对面接触,并评估其相关性及其相关因素。设计与环境2010年6月—2011年5月,丹麦基层医疗中非工作时间的一项前瞻性观察研究。方法从电子病例管理系统中收集患者的信息,并由全科医生完成与联络相关的电子问卷。进行面对面接触的全科医生评估了电话分诊到面对面接触的相关性。进行二项回归分析,计算相对危险度(RR)和95%CI。结果 59.2%的电话呼入以电话咨询结束。电话分诊到面对面接触的相关因素如下:患者年龄>40岁(40~64岁:RR=1.13;年龄>64岁:RR=1.34)、问题持续存在12~24 h(RR=2.60)、潜在的严重问题(RR=5.81)和非严重问题(RR=2.23)。研究发现,电话分诊到面对面接触与12.7%的诊所咨询和11.7%的家访无关。问题持续存在>24 h(RR=1.25)、在每个工作日晚上联系(RR=1.25)、距离患者拥有全科医疗时间<2 h(RR=1.80)无关。结论本文中全科医生认为约12%的面对面咨询与电话分诊无关,这表明全科医生电话分诊是有效的。了解电话分诊的影响因素可以为全科医生提供更好的教育,但仍需对全科医生电话分诊的其他质量方面进行前瞻性研究。
Background In the United Kingdom, telephone triage at non-working hours in primary care is mostly run by nurses and by general practitioners in Denmark. Purpose Describe from a general practitioner’s telephone triage to face-to-face contact and assess their relevance and its associated factors. Design and Environment A prospective observational study of non-working hours in primary care in Denmark from June 2010 to May 2011. Methods The patient’s information was collected from the electronic case management system and the contact-related electronic questionnaire was completed by the GP. The face-to-face surgeons assesses the relevance of phone triage to face-to-face contact. Two regression analyzes were performed to calculate relative risk (RR) and 95% CI. As a result, 59.2% of telephone inquiries ended by telephone consultation. The factors associated with face-to-face contact break-up were as follows: Patients aged> 40 years (40-64 years: RR = 1.13; age> 64 years: RR = 1.34) had problems persisting for 12-24 hours (RR = 2.60) Serious problems (RR = 5.81) and non-Serious problems (RR = 2.23). The study found that phone triage to face-to-face contact was not associated with 12.7% of clinic consultations and 11.7% of home visits. The problem persisted for> 24 h (RR = 1.25), linked on a working-day night (RR = 1.25), independent of patients having GPh <2 h (RR = 1.80). Conclusion In this article, GPs consider that about 12% of face-to-face consultations are not related to telephone triage, suggesting that GP triage is effective. Understanding the factors that affect the triage of telephones can provide GPs a better education, but prospective studies of other quality aspects of GP triage are still required.