Patient preferences for care by general internists and specialists in the ambulatory setting
Patient preferences for care by general internists and specialists in the ambulatory setting
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DOI：
10.1046/j.1525-1497.2000.05089.x
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发表时间：
2000-02-01
影响因子：
5.7
通讯作者：
Hayden, J
中科院分区：
文献类型：
--
作者：
Lewis, CL;Wickstrom, GC;Hayden, J
目的：调查患者对普通内科医生和专科医生对常见医疗状况的护理的偏好。设计：电话访谈。设置：东部 10 个学术医疗中心的普通内科实践的便利样本。患者/参与者：314 名参与者的概率样本，他们在过去 2 年内至少看过一次初级保健医生。测量和主要结果：涉及患者对连续性护理的态度、对护理的偏好的项目。普通内科医生或专科医生对常见医疗问题的护理，以及对普通内科医生和专科医生处理这些问题的能力的看法。连续性对参与者来说很重要，63% 的人表示他们更喜欢有一名医生。受访者愿意等待 3 或 4 天去看他们的常规医生 (85%)，并希望他们的医生在急诊室给他们看病 (77%) 并在医院期间监控他们的护理情况 (94%)。大多数人 (>60%) 在面对各种新情况时更愿意接受常规医生的治疗。尽管受访者重视连续性，但 84% 的受访者认为，无需转诊即可向任何类型的医生寻求医疗护理非常重要，74% 的受访者表示，如果他们需要看专科医生，他们愿意自付费用。尽管大多数参与者 (98%) 认为他们的常规医生能够解决常见的医疗问题，但大多数人认为专科医生能够更好地治疗过敏症 (79%)，并且能够更好地开出治疗抑郁症 (65%) 和腰痛 (72%) 的药物。 结论：参与者更愿意去看普通内科医生，尽管他们认为专科医生更有能力治疗我们检查的病症。然而，他们希望不受限制地接触专家，以补充普通内科医生提供的护理。
OBJECTIVE: To investigate patients' preferences for care by general internists and specialists for common medical conditions.DESIGN: Telephone interview.SETTING: A convenience sample of general internal medicine practices at 10 eastern academic medical centers.PATIENT/PARTICIPANTS: A probability sample of 314 participants who had at least one visit with their primary care physician during the preceding 2 years.MEASUREMENTS AND MAIN RESULTS: Items addressed patients' attitudes concerning continuity of care, preferences for care by general internists or specialists for common medical problems, and perceptions about the competency of general internists and specialists to manage these problems. Continuity was important to participants, with 63% reporting they preferred having one doctor. Respondents were willing to wait 3 or 4 days to see their regular doctor (85%) and wanted their doctor to see them in the emergency department (77%) and monitor their care while in the hospital (94%). A majority (>60%) preferred care from their regular doctor for a variety of new conditions. Though respondents valued continuity, 84% felt it was important to be able to seek medical care from any type of physician without a referral, and 74% responded that if they needed to see a specialist, they were willing to pay out-of-pocket to do so. Although most participants (98%) thought their regular doctor was able to take care of usual medical problems, the majority thought that specialists were better able to care for allergies (79%) and better able to prescribe medications for depression (65%) and low-back pain (72%),CONCLUSIONS: Participants preferred to see their general internist despite their perceptions that specialists were more competent in caring for the conditions we examined. However, they wanted unrestricted access to specialists to supplement care provided by general internists.