Defining primary care sensitive conditions: a necessity for effective primary care delivery?
Defining primary care sensitive conditions: a necessity for effective primary care delivery?
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DOI：
10.1258/jrsm.2012.120178
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发表时间：
2012-10-01
影响因子：
17.3
通讯作者：
Majeed, Azeem
中科院分区：
文献类型：
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作者：
Gibbons, Daniel C.;Bindman, Andrew B.;Majeed, Azeem
初级保健是英格兰国民保健服务（NHS）的主要组成部分，每年约有3亿名全科医生在英格兰进行咨询，占NHS所有患者接触的70-90%。除了向注册人口提供医疗服务外，全科医生还负责协调和把关由二级医疗保健、三级医疗保健和其他联合医疗保健提供者提供的服务。由于全科医生将在英格兰的医疗服务中扮演关键角色，因此很明显有机会通过关注最适合初级保健管理的疾病来重塑医疗服务模式，以最大限度地提高结果、成本效率和患者可及性。至关重要的是，有证据表明，在初级保健管理中，哪些条件最敏感，通常被称为初级保健敏感条件或门诊敏感条件。这样的定义将有助于资源规划、起草地方管理协议和简化一些慢性病的初级和二级保健之间的接口。事实上，对二级医疗资源的不当利用可能会给医疗保健提供者带来巨大的机会成本，而对患者来说可能不太可取。
Primary care is a major component of England's National Health Service (NHS), responsible for approximately 300 million consultations per year with GPs in England, which represents 70-90% of all patient contacts with the NHS. In addition to providing healthcare to the registered population, GPs are charged with coordination and gatekeeping of access to services provided by secondary care, tertiary care and other allied healthcare providers. As GPs will be assuming a key role in commissioning health services in England, there is a clear opportunity to re-model care delivery to maximize outcomes, cost efficiency and patient access by focusing on diseases that are most amenable to management in primary care. It is essential that there is evidence to inform what conditions are most sensitive to management in primary care commonly referred to as primary care sensitive conditions or ambulatory care sensitive conditions. Such definitions would aid resource planning, drafting of local management protocols and simplification of the interface between primary and secondary care for a number of chronic conditions. Indeed, inappropriate utilization of secondary care resources is likely to represent a significant opportunity cost to healthcare providers and may be less desirable for patients.