干预过度使用在儿科护理在澳大利亚大都市全科医生。

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Australian Journal of General Practice Pub Date : 2025-06-01 DOI:10.31128/AJGP-09-24-7399

Tammy Meyers Morris, Lena Sanci, Alannah Rudkin, Cecilia Moore, Kim Dalziel, Siaw-Teng Liaw, Brendan Goodger, Gary Freed, Karen Wheeler, Stephanie Germano, Jane Le, Sonia Khano, Michael Hodgins, Harriet Hiscock, Raghu Lingam

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引用次数: 0

摘要

背景和目的：全科医生（GP）提供的低价值儿科初级保健(LVC)/干预过度使用没有常规评估。本文的目的是评估患病率，相关的GP特征和GP提供的LVC治疗五种常见儿科疾病的成本。方法：从悉尼和墨尔本的22家诊所中提取患者水平的数据。对全科医生进行调查，评估LVC的成本。结果：628/6182（10.2%）就诊患者使用了LVC，其中上呼吸道感染患者使用了抗生素（511/4469,11.4%）。执业15年的全科医生显示出提供LVC的风险增加(风险差[RD] 9.8%；95%置信区间[CI]: 4.0至15.6)，与批量计费相比，私人计费的LVC发生率更低(RD为7.2%；95% CI: 2.9 - 11.5)，女性gp与男性gp (RD -4.5%；95% CI: -8.7 ~ -0.4)。估计LVC费用为17,254.15美元，如果应用于所有澳大利亚LVC儿科就诊，则推断为4120万美元。讨论：低水平干预过度使用在城市全科医生中继续存在。针对相关全科医生特征的有针对性的质量改进方法可能会加强儿科护理。

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Intervention overuse in paediatric care in Australian metropolitan general practice.

Background and objectives: General practitioner (GP)-provided low-value paediatric primary care (LVC)/intervention overuse is not routinely evaluated. The aim of this paper is to evaluate prevalence, associated GP characteristics and cost of GP-provided LVC for five common paediatric conditions.

Method: Patient-level data were extracted from 22 practices in Sydney and Melbourne. GPs were surveyed and costs of LVC were evaluated.

Results: LVC was provided in 628/6182 (10.2%) consultations, including antibiotics for upper respiratory tract infections (511/4469, 11.4%). GPs practising for >15 years demonstrated increased risk of providing LVC (risk difference [RD] 9.8 %; 95% confidence interval [CI]: 4.0 to 15.6), and LVC occurred less at private versus bulk billing practices (RD 7.2 %; 95% CI: 2.9 to 11.5) and with female versus male GPs (RD -4.5%; 95% CI: -8.7 to -0.4). Estimated LVC cost was $17,254.15, extrapolated to $41.2 million when applied to all Australian LVC paediatric visits.

Discussion: Low-level intervention overuse continues among urban GPs. Targeted quality improvement approaches addressing associated GP characteristics might strengthen paediatric care.

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来源期刊

Australian Journal of General Practice Medicine-Family Practice

CiteScore

2.80

自引率

4.50%

发文量

284

期刊介绍： The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.