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全科医疗中的医疗参与和组织特征

Medical engagement and organizational characteristics in general practice.

作者信息

Ahnfeldt-Mollerup Peder, dePont Christensen René, Halling Anders, Kristensen Troels, Lykkegaard Jesper, Nexøe Jørgen, Barwell Fred, Spurgeon Peter, Søndergaard Jens

机构信息

Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark,

Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.

出版信息

Fam Pract. 2016 Feb;33(1):69-74. doi: 10.1093/fampra/cmv085. Epub 2015 Oct 26.

Abstract

BACKGROUND

Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale (MES) was developed by Applied Research Ltd (2008) on the basis of emerging evidence that medical engagement is critical for implementing radical improvements.

OBJECTIVES

To study the importance of medical engagement in general practice and to analyse patterns of association with individual and organizational characteristics.

DESIGN AND SETTING

A cross-sectional study using a sampled survey questionnaire and the official register from the Danish General Practitioners' Organization comprising all registered Danish GPs.

METHOD

The Danish version of the MES Questionnaire was distributed and the survey results were analysed in conjunction with the GP register data.

RESULTS

Statistically adjusted analyses revealed that the GPs' medical engagement varied substantially. GPs working in collaboration with colleagues were more engaged than GPs from single-handed practices, older GPs were less engaged than younger GPs and female GPs had higher medical engagement than their male colleagues. Furthermore, GPs participating in vocational training of junior doctors were more engaged than GPs not participating in vocational training.

CONCLUSION

Medical engagement in general practice varies a great deal and this is determined by a complex interaction between both individual and organizational characteristics. Working in collaboration, having staff and being engaged in vocational training of junior doctors are all associated with enhanced levels of medical engagement among GPs.

摘要

背景

医疗参与是一个相互的概念,指医生为维持和提升其医疗保健机构的绩效做出积极贡献,而该机构本身也认可这种在支持和鼓励高质量医疗方面的承诺。应用研究有限公司(2008年)基于新出现的证据开发了一个医疗参与量表(MES),该证据表明医疗参与对于实施根本性改进至关重要。

目的

研究医疗参与在全科医疗中的重要性,并分析与个人及组织特征的关联模式。

设计与背景

一项横断面研究,使用抽样调查问卷以及丹麦全科医生组织的官方登记册,该登记册涵盖了所有注册的丹麦全科医生。

方法

分发MES问卷的丹麦语版本,并结合全科医生登记数据对调查结果进行分析。

结果

经统计调整的分析显示,全科医生的医疗参与程度差异很大。与同事合作的全科医生比独自执业的全科医生参与度更高,年长的全科医生比年轻的全科医生参与度更低,女全科医生比男同事的医疗参与度更高。此外,参与初级医生职业培训的全科医生比未参与职业培训的全科医生参与度更高。

结论

全科医疗中的医疗参与差异很大,这是由个人和组织特征之间复杂的相互作用决定的。合作工作、配备员工以及参与初级医生职业培训都与全科医生更高水平的医疗参与相关。

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