Diagnostic scope in out-of-hours primary care services in eight European countries: an observational study.
Diagnostic scope in out-of-hours primary care services in eight European countries: an observational study.
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DOI：
10.1186/1471-2296-12-30
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发表时间：
2011-05-13
影响因子：
2.9
通讯作者：
Wensing M
中科院分区：
文献类型：
--
作者：
Huibers LA;Moth G;Bondevik GT;Kersnik J;Huber CA;Christensen MB;Leutgeb R;Casado AM;Remmen R;Wensing M
在过去几年中，许多国家的大型组织都组织了非工作时间的初级保健。这可能降低了许多患者在夜间和周末出现健康问题的门槛。要比较各国的非工作时间护理情况，就需要有国际上可比较的症状和诊断数字，而这些数字是无法获得的。本研究旨在描述八个欧洲国家地区的非工作时间初级保健服务的症状和诊断。我们根据比利时、丹麦、德国、荷兰、挪威、斯洛文尼亚、西班牙和瑞士的非工作时间初级保健服务的病历进行了一项回顾性观察研究。我们的目标是包括来自每个国家最多三个组织的1000个初始联系人的数据。排除了与管理原因有关的接触。国际初级保健分类（ICPC）用于对症状和诊断进行分类。在两个国家（斯洛文尼亚和西班牙），ICD 10编码被翻译成ICPC编码。患者的年龄分布在各国之间显示出高度一致性，而男性的百分比从33.7%到48.3%不等。最常使用的ICPC类别涉及：A章“一般和未指明症状”（平均13.2%）、R章“呼吸道”（平均20.4%）、L章“肌肉骨骼”（平均15.0%）、S章“皮肤”（平均12.5%）和D章“消化道”（平均11.6%）。因此，相对较多的患者出现感染性疾病或急性疼痛相关综合征。这在各年龄组之间基本一致，但在某些年龄组中，经常使用H章（“耳部问题”）、L章（“肌肉骨骼”）和K章（“心血管”）。急性危及生命的问题发生率较低。这项国际研究表明，在非工作时间的初级保健服务中，诊断范围非常相似。在所有国家，危及生命的急性健康问题的发生率都很低。
In previous years, out- of-hours primary care has been organised in large-scale organisations in many countries. This may have lowered the threshold for many patients to present health problems at nights and during the weekend. Comparisons of out-of-hours care between countries require internationally comparable figures on symptoms and diagnoses, which were not available. This study aimed to describe the symptoms and diagnoses in out-of-hours primary care services in regions in eight European countries. We conducted a retrospective observational study based on medical records from out-of-hours primary care services in Belgium, Denmark, Germany, the Netherlands, Norway, Slovenia, Spain, and Switzerland. We aimed to include data on 1000 initial contacts from up to three organisations per country. Excluded were contacts with an administrative reason. The International Classification for Primary Care (ICPC) was used to categorise symptoms and diagnoses. In two countries (Slovenia and Spain) ICD10 codes were translated into ICPC codes. The age distribution of patients showed a high consistency across countries, while the percentage of males varied from 33.7% to 48.3%. The ICPC categories that were used most frequently concerned: chapter A 'general and unspecified symptoms' (mean 13.2%), chapter R 'respiratory' (mean 20.4%), chapter L 'musculoskeletal' (mean 15.0%), chapter S 'skin' (mean 12.5%), and chapter D 'digestive' (mean 11.6%). So, relatively high numbers of patients presenting with infectious diseases or acute pain related syndromes. This was largely consistent across age groups, but in some age groups chapter H ('ear problems'), chapter L ('musculoskeletal') and chapter K ('cardiovascular') were frequently used. Acute life-threatening problems had a low incidence. This international study suggested a highly similar diagnostic scope in out-of-hours primary care services. The incidence rates of acute life-threatening health problems were low in all countries.
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影响因子：
2.2
作者：
Seifert, Bohumil;Svab, Igor;Byma, Svatopluk
通讯作者：
Byma, Svatopluk
影响因子：
3.5
作者：
van Charante, Eric Peter Moll;ter Riet, Gerben;Bindels, Patrick
通讯作者：
Bindels, Patrick
影响因子：
2.2
作者：
Car, J;Svab, I;Vegnuti, M
通讯作者：
Vegnuti, M
影响因子：
9.7
作者：
Grol, Richard;Giesen, Paul;van Uden, Caro
通讯作者：
van Uden, Caro
影响因子：
105.7
作者：
Bindman, Andrew B.;Forrest, Christopher B.;Majeed, Azeem
通讯作者：
Majeed, Azeem