更好的在一起吗?法国全科医生多专业群体执业绩效的中介分析

IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES
Health Services Insights Pub Date : 2025-05-06 eCollection Date: 2025-01-01 DOI:10.1177/11786329251331128
Anna Zaytseva, Pierre Verger, Bruno Ventelou
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引用次数: 0

摘要

背景:综合初级保健团队在家庭医学中仍然是一项有争议的政策,这可能是对法国医疗密度短缺的一种方便的反应。目的:分析全科医生(GP)如何应对其执业区域的全科医生供应不足(护理的数量和质量),以及这种反应如何通过综合初级保健团队-多专业团体实践(mgp)的注册来调解。方法:采用结构方程模型对1209名法国gp进行3次代表性横断面调查(2019-2020)。护理的数量和质量由潜在变量估计,潜在变量分别包括全科医生的需求、吸收能力和疫苗推荐频率。结果:在没有潜在介质的情况下,低GP密度与数量呈负相关(-0.221,未标准化的直接效应),但与护理质量无关。在中介存在的情况下,低GP密度与较高的工作压力相关(0.120),继而与需求吸收能力恶化相关(-0.202)。更多地使用电子卫生工具与更多地参与疫苗建议相关(0.357)。mgp内的全科医生比在mgp外执业的全科医生倾向于使用更多的电子卫生工具(0.032),这对疫苗推荐有有利影响。结论:较低的工作压力水平是处理患者要求的关键中介因素。当校正自我选择进入mgp时,我们发现mgp的入组对护理数量没有显著的中介效应,但对护理质量有显著的影响。我们的研究结果指出了mgp注册对护理质量的附加价值,倡导其进一步发展。凝胶分类:I14, I18。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Better Together? A Mediation Analysis of French General Practitioners' Performance in Multi Professional Group Practice.

Background: Integrated primary care teams remain a debatable policy in family medicine that could be a convenient response to French shortages in medical density.

Objectives: To analyse how general practitioners (GPs) respond to insufficient GP supply in their practice area in terms of quantity and quality of care, and how this response is mediated by enrolment in integrated primary care teams - multi-professional group practices (MGPs).

Methods: We used structural equation modelling on 3 representative cross-sectional surveys (2019-2020) of 1209 French GPs. Quantity and quality of care were approximated by latent variables comprising respectively GPs' demand absorption capacity and frequencies of vaccine recommendations.

Results: In the absence of potential mediators, low GP density was negatively associated with quantity (-0.221, unstandardized direct effects), but not with the quality of care. In the presence of mediators, low GP density was associated with higher work-related stress (0.120), which was consecutively associated with deteriorated demand absorption capacity (-0.202). Higher use of e-health tools was associated with greater involvement in vaccine recommendations (0.357). GPs in MGPs tended to use more e-health tools than those practicing outside MGPs (0.032), with a favourable effect on vaccine recommendations.

Conclusion: Lower level of work-related stress is the key mediator in handling patients' requests. When correcting for self-selection into MGPs, we found no significant mediation effect of enrolment in MGPs on the quantity of care but rather an effect on the quality of care. Our results pinpoint an added value of an enrolment in an MGPs to care quality that advocates for its further development.

Jel classification: I14, I18.

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来源期刊
Health Services Insights
Health Services Insights HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.60
自引率
0.00%
发文量
47
审稿时长
8 weeks
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