Home visits in German general practice: Findings from routinely collected computer data of 158,000 patients
Home visits in German general practice: Findings from routinely collected computer data of 158,000 patients
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DOI：
10.1055/s-2007-993181
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发表时间：
2007-12-01
期刊：
影响因子：
1.1
通讯作者：
Junius-Walker, U.
中科院分区：
文献类型：
--
作者：
Snijder, E. A.;Kersting, M.;Junius-Walker, U.
家访是全科医疗的一个组成部分。然而，德国缺乏这方面的资料。因此，我们的目的是描述家访的数量，目标人群和工作量的全科医生的计算机数据常规收集在全科医生的基础上。方法：常规护理资料来源于哥廷根和弗莱堡地区136例实践。电子病历提供了出诊和会诊的账单代码、患者的匿名识别码、年龄、性别和ICD代码。结果：2002年有84个实践，158383例患者的完整数据集可用于横断面分析。所有患者中有12%需要至少一次家访——老年人和女性患者明显更多。在所有到家中就诊的患者中，有一半要求一次就诊，而近5%的患者全年至少需要两次就诊。2/3的患者接受了急诊。疾病的数量和性质对家访状况也有影响。每100次咨询平均需要9次就诊。15种做法提供了1997年至2001年间的数据集。在此期间，家访总数有所下降。在同一时期，目标人群越来越局限于老年患者。结论：年龄、女性、疾病数量和疾病性质对家访状况有正向影响。与其他欧洲国家的一般做法相比，在这个德国样本中，由上门服务引起的工作量似乎很高。近年来，家访的频率有所下降。鉴于人口结构的变化，必须决定由谁来照顾越来越多需要家访的老病人。
Introduction: Home visits are an integral part of general practice. However, information on this subject is lacking in Germany. Therefore we aim to describe the quantity of home visits, the target population and the workload for general practitioners on the basis of computerised data routinely collected in general practices. Methods: The routine care data originate from 136 practices of the areas of Gottingen and Freiburg. Electronic patient records provided billing codes for home visits and consultations, patients' anonymous identification number, age, gender and ICD codes. Results: 84 practices with complete datasets of 158,383 patients were available for the cross-sectional analysis in 2002. 12% of all patients required at least one home visit - significantly more elderly and female patients. Half of all patients visited at home requested one visit, whereas nearly 5% needed at least fortnightly visits throughout the year. 2/3 of all visited patients received an emergency visit. The quantity and nature of diseases also influenced home visit status. The workload of an average practice contained 9 visits per 100 consultations. 15 practices provided datasets between 1997 and 2001. In this period the total number of home visits declined. Within the same period, the target group has increasingly been restricted to old patients. Conclusion: Old age, female gender, quantity and nature of diseases positively influence home visit status. Compared to general practices in other European countries, the workload caused by house calls seems high in this German sample. Over recent years the frequency of home visits has decreased. In view of the demographic changes, decisions will have to be made as to who will care for the growing numbers of old patients requiring home visits.