اکتشاف از ویژگی های جمعیت و عمل توضیح در مورد تفاوت بین شیوه در نسبت بستری شدن در بیمارستان که شرایط اضطراری هستند
Exploration of population and practice characteristics explaining differences between practices in the proportion of hospital admissions that are emergencies
نویسندگان |
این بخش تنها برای اعضا قابل مشاهده است ورودعضویت |
اطلاعات مجله |
Wiseman and BakerBMC Family Practice2014,15:101 http://www.biomedcentral.com/1471-2296/15/101 |
سال انتشار |
2014 |
فرمت فایل |
PDF |
کد مقاله |
21209 |
پس از پرداخت آنلاین، فوراً لینک دانلود مقاله به شما نمایش داده می شود.
چکیده (انگلیسی):
Background:Emergency (unscheduled) and elective (scheduled) use of secondary care varies between practices.
Past studies have described factors associated with the number of emergency admissions; however, high quality
care of chronic conditions, which might include increased specialist referrals, could be followed by reduced
unscheduled care. We sought to characterise practices according to the proportion of total hospital admissions that
were emergency admissions, and identify predictors of this proportion.
Method:The study included 229 general practices in Leicestershire, Northamptonshire and Rutland, England.
Publicly available data were obtained on scheduled and unscheduled secondary care usage, and on practice and
patient characteristics: age; gender; list size; observed prevalence, expected prevalence and the prevalence gap of
coronary heart disease, hypertension and stroke; deprivation; headcount number of GPs per 1000 patients; total and
clinical quality and outcomes framework (QOF) scores; ethnicity; proportion of patients seen within two days by a
GP; proportion able to see their preferred GP. Using the proportion of admissions that were emergency admissions,
seven categories of practices were created, and a regression analysis was undertaken to identify predictors of
the proportion.
Results:In univariate analysis, practices with higher proportions of admissions that were emergencies tended to
have fewer older patients, higher proportions of male patients, fewer white patients, greater levels of deprivation,
smaller list sizes, lower recorded prevalence of coronary heart disease and stroke, a bigger gap between the
expected and recorded levels of stroke, and lower proportions of total and clinical QOF points achieved. In the
multivariate regression, higher deprivation, fewer white patients, more male patients, lower recorded prevalence of
hypertension, more outpatient appointments, and smaller practice list size were associated with higher proportions
of total admissions being emergencies.
Conclusion:In monitoring use of secondary care services, the role of population characteristics in determining
levels of use is important, but so too is the ability of practices to meet the demands for care that face them. The
level of resources, and the way in which available resources are used, are likely to be key in determining whether a
practice is able to meet the health care needs of its patients.
کلمات کلیدی مقاله (فارسی):
مراقبت های اولیه، خدمات بهداشتی و درمانی، برنامه ریزی بهداشت
کلمات کلیدی مقاله (انگلیسی):
Keywords:Primary care, Health services, Health planning
پس از پرداخت آنلاین، فوراً لینک دانلود مقاله به شما نمایش داده می شود.