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使用面对面咨询的替代方式:一项关于全科医疗中患病率和态度的调查。

Using alternatives to face-to-face consultations: a survey of prevalence and attitudes in general practice.

作者信息

Brant Heather, Atherton Helen, Ziebland Sue, McKinstry Brian, Campbell John L, Salisbury Chris

出版信息

Br J Gen Pract. 2016 Jul;66(648):e460-6. doi: 10.3399/bjgp16X685597. Epub 2016 May 23.

Abstract

BACKGROUND

The ubiquitous use of communication technologies has led to an expectation that a similar approach should extend to health care. Despite considerable rhetoric about the need for general practices to offer alternatives to face-to-face consultations, such as telephone, email, and internet video consultations, the extent to which such technologies are actually used at present is unclear.

AIM

The aim of the survey was to identify the frequency and range of ways in which general practices are providing (or planning) alternatives to face-to-face consultations.

DESIGN AND SETTING

A postal survey of practices around Bristol, Oxford, Lothian, the Highlands, and the Western Isles of Scotland.

METHOD

A postal questionnaire survey was sent to each of the GPs and practice managers of 421 practices between January and May 2015.

RESULTS

A response was received from 319/421 practices (76%). Although the majority of the practices reported that they were conducting telephone consultations frequently (n = 211/318, 66%), fewer were implementing email consultations (n = 18/318, 6%), and most (n = 169/318, 53%) had no plans to introduce this. None were currently using internet video, and 86% (n = 273/318) had no plans to introduce internet video consultations. These findings were repeated in the reported use of alternatives to face-to-face consultations at an individual GP level. Optional free text responses were completed by 28% of responders, and offered an explanation for the (often perceived) barriers and incentives for implementation.

CONCLUSION

Despite policy pressure to introduce consultations by email and internet video, there is a general reluctance among GPs to implement alternatives to face-to-face consultations. This identifies a substantial gap between rhetoric and reality in terms of the likelihood of certain alternatives (email, video) changing practice in the near future.

摘要

背景

通信技术的广泛使用引发了一种期望,即类似的方法应扩展到医疗保健领域。尽管有大量言论强调普通诊所需要提供面对面咨询的替代方式,如电话、电子邮件和互联网视频咨询,但目前这些技术的实际使用程度尚不清楚。

目的

该调查的目的是确定普通诊所在提供(或计划提供)面对面咨询替代方式的频率和范围。

设计与地点

对布里斯托尔、牛津、洛锡安、高地和苏格兰西部群岛周边的诊所进行邮政调查。

方法

2015年1月至5月期间,向421家诊所的每位全科医生和诊所经理发送了邮政问卷调查。

结果

收到了319/421家诊所(76%)的回复。虽然大多数诊所报告称他们经常进行电话咨询(n = 211/318,66%),但实施电子邮件咨询的较少(n = 18/318,6%),且大多数(n = 169/318,53%)没有引入电子邮件咨询的计划。目前没有一家诊所使用互联网视频,86%(n = 273/318)没有引入互联网视频咨询的计划。在个体全科医生层面报告的面对面咨询替代方式的使用情况中也出现了这些结果。28%的受访者填写了可选的自由文本回复,对实施(通常被认为的)障碍和激励因素进行了解释。

结论

尽管有政策压力要求引入电子邮件和互联网视频咨询,但全科医生普遍不愿实施面对面咨询的替代方式。这表明在某些替代方式(电子邮件、视频)在不久的将来改变医疗实践的可能性方面,言论与现实之间存在巨大差距。

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