WONCA研究论文摘要汇编——全科医生为委托带来的“附加值”:初级医疗定性研究

发布时间：2018-05-10 16:22

本文选题：WONCA + 临床医生　；参考：《中国全科医学》2015年19期

【摘要】：背景英国《2012年健康和社会保健法案》取缔了初级保健信托,建立临床医生委托团体(clinical commissioning groups,CCGs)为主要购买机构。CCGs由全科医生(GPs)领导,主张加大投入以完善委托实践。目的检验CCGs的一些关键假设,评估GPs给委托带来的"附加值"。方法 2013年4—9月,对英格兰7个CCGs团体的临床医生及管理者进行了深度访谈。共有40名临床医生和管理者参加了访谈。访谈聚焦GPs对委托带来的附加值。结果受访者认为GPs的附加值主要在于他们对病人的了解。然而,关于对病人的详细了解能否改善服务设计,以及GPs与管理者之间的紧密合作能否增强管理者的交涉能力,被访者的意见并不一致。此外,受访者还对繁重的工作和参与更大GPs队伍工作的困难表示担忧。结论自20世纪90年代费用负责制(注:英国政府发给GPs支付某些医院服务费用的制度)实施以来,GPs就以各种方式参与委托实践,因而对于此类主张似乎并不陌生。关键问题是这些新机构能否提供更好的帮助,能否有效地运用此类知识。此外,对经验性知识的过度关注引发了担忧,因为这可能会影响代表性和其他意见的采纳。总之,GPs的个人知识是否优于系统的公共卫生情报还需进一步探究。
[Abstract]:Background the Health and Social Health Care Act of 2012 in England abolished the primary health care trust and set up clinical commissioning groups as the main purchasing organization. CCGs was led by General Practitioners (GPs) and advocated increasing investment to perfect the practice of entrustment. Objective to test some key assumptions of CCGs and evaluate the added value of GPs to delegation. Methods from April to September 2013, the clinicians and managers of seven CCGs groups in England were interviewed in depth. A total of 40 clinicians and administrators were interviewed. The interview focused on the added value GPs brings to the commission. Results respondents believed that the added value of GPs was their understanding of patients. However, interviewees did not agree on whether a detailed understanding of patients could improve service design and whether close collaboration between GPs and managers would enhance managers' bargaining power. In addition, respondents expressed concern about heavy work and the difficulty of participating in a larger GPs team. Conclusion since the implementation of the cost responsibility system in the 1990s, GPs have been involved in the practice of entrustment in various ways since the British government issued the GPs to pay for certain hospital services, so it seems that this kind of proposition is no stranger. The key question is whether these new institutions can provide better help and use such knowledge effectively. In addition, excessive attention to empirical knowledge raises concerns that it may affect representativeness and the adoption of other views. In a word, whether GPs' personal knowledge is superior to systematic public health information needs to be further explored.
【分类号】：R197.1

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