German GPs' willingness to expand roles of physician assistants: a regional survey of perceptions and informal practices influencing uptake of health reforms in primary health care
German GPs' willingness to expand roles of physician assistants: a regional survey of perceptions and informal practices influencing uptake of health reforms in primary health care
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DOI：
10.1093/fampra/cmr127
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发表时间：
2012-08-01
期刊：
影响因子：
2.2
通讯作者：
Braun, Vittoria
中科院分区：
文献类型：
--
作者：
Dini, Lorena;Sarganas, Giselle;Braun, Vittoria
许多保健人员短缺的国家正在实行初级保健的任务转移。全科医生的态度和做法强烈影响任务转移和医生助理（PA）的角色扩展。为了评估，在德国一个卫生人员短缺的州，全科医生将家访任务委托给私人助理的总体意愿，并了解他们对这种委托的障碍和好处以及目前非正式委托的做法的看法。对梅克伦堡-沃尔波梅尔恩农村地区的所有执业全科医生进行匿名调查。主要结果是全科医生是否愿意将家访任务委托给经过适当培训的私人助理，对家访代表团的障碍和好处的认识，以及目前非正式代表团的做法。使用多项逻辑回归分析，结果变量、全科医生的特征和他们的实践之间的关联被确定，应答率为47%。应答者（500）与该州所有全科医生（1096）相当; 48%的从业者愿意将家访任务委托给私人助理。授权的主要障碍是私人助理培训的相关费用（34%），而其主要好处是“节省全科医生的时间”（67%）。46%的非正式委托家访任务的从业者更可能是年轻[比值比（OR）和95%置信区间（CI）] [OR = 0.96（0.93-0.99）]和女性[OR = 1.70（1.12-2.58）]。
Many countries with shortages in health personnel are introducing task shifting in primary health care. GPs' attitudes and practices strongly affect task shifting and the expansion of the roles of physician assistants (PAs).To assess, in a German state with shortages of health personnel, the overall willingness of GPs to delegate home visit tasks to PAs and to elicit their perceptions of barriers to and benefits of such delegation and the current practice of informal delegation.Postal self-administered anonymous survey of all practicing GPs in the rural state of Mecklenburg-Vorpommern. Main outcomes were GPs' willingness to delegate in home visit tasks to a properly trained PA, perceived barriers to and benefits of home visit delegation and current practice of informal delegation. Using multinomial logistic regression, associations were identified among outcome variables, and characteristics of the GPs and of their practices.Response rate was 47%. Responders (500) were comparable to all GPs in the state (1096); 48% of practitioners are willing to delegate home visits tasks to PAs. The main barrier to delegation was the related costs of PAs' training (34%), and the main benefit that it 'saves the GP's time' (67%). The 46% of practitioners who are informally delegating home visit tasks were significantly more likely be younger [odds ratio (OR) and 95% confidence interval (CI)] [OR = 0.96 (0.93-0.99)] and female [OR = 1.70 (1.12-2.58)].The increasing proportion of women in family medicine might favor task shifting in General Practice.