US Generalist Physicians and Groups That Focused Practice in a Single Care Setting: 2014-2017.
US Generalist Physicians and Groups That Focused Practice in a Single Care Setting: 2014-2017.
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DOI：
10.1097/mlr.0000000000001778
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发表时间：
2022-11-01
期刊：
影响因子：
3
通讯作者：
Jung, Hye-Young
中科院分区：
文献类型：
--
作者：
Ryskina, Kira L.;Unruh, Mark Aaron;Qian, Yuting;Jung, Hye-Young
一些接受过初级保健培训的全科医生越来越多地在一个机构执业（例如，医院、疗养院）;然而，这一趋势是否伴随着全科医生的免费增加，他们的做法集中在办公室为基础的护理是未知的。我们在这项研究中的目的是检查在一个单一的设置实践的全科医生和医生群体的流行趋势。这是一项回顾性横断面研究，对象为接受过家庭医学、内科学或老年医学培训的全科医生。我们使用2014-2017年医疗保险按服务收费受益人的账单数据来衡量医生在以下护理环境中进行的所有患者访问的比例：办公室，门诊部，住院医院和其他网站。从2014年到2017年，将执业范围缩小到单一环境的全科医生比例增加了6.69%（从62.80%增加到67.00%，pfor趋势<0.001）。2017年，4.63%的医生群体包括一种以上的基于设置的医生。治疗老年人的全科医生越来越多地将他们的实践重点缩小到单一类型的医疗保健环境。这种趋势并没有伴随着包括不同类型的基于设置的医生的医生群体的增长。需要进一步评估这些趋势对不同卫生保健环境和初级保健结果的初级保健服务碎片化的影响。
Some generalist physicians whose training prepared them for primary care practice increasingly practice in a facility (e.g., hospitals, nursing homes); however, whether this trend was accompanied by a complimentary rise in generalist physicians who focused their practice on office-based care is unknown. Our objective in this study was to examine trends in the prevalence of generalist physicians and physician groups that practice in a single setting. This was a retrospective cross-sectional study of generalist physicians trained in family medicine, internal medicine, or geriatrics. We used 2014–2017 billing data for Medicare fee-for-service beneficiaries to measure the proportion of all patient visits made by physicians in the following care settings: office, outpatient hospital department, inpatient hospital, and other sites. From 2014 to 2017, the proportion of generalist physicians who narrowed their practice to a single setting increased by 6.69% (from 62.80% to 67.00%, pfor trend<0.001). In 2017, 4.63% of physician groups included more than one type of setting-based physicians. Generalist physicians treating older adults increasingly narrowed their practice focus to a single type of health care setting. This trend was not accompanied by growth among physician groups that included different types of setting-based physicians. Further evaluation of the consequences of these trends on the fragmentation of primary care delivery across different health care settings and primary care outcomes is needed.
影响因子：
6.3
作者：
Kuo YF;Goodwin JS
通讯作者：
Goodwin JS
影响因子：
6.3
作者：
Ryskina KL;Wang H;Foley KA;Merchant RM
通讯作者：
Merchant RM