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任务转移以提高实践效率:德国巴登-符腾堡州非城市地区全科医生的调查。

Task shifting to improve practice efficiency: A survey among general practitioners in non-urban Baden-Wuerttemberg, Germany.

机构信息

Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Heidelberg University Medical Faculty Mannheim, Mannheim, Germany.

Division of Prevention of Cardiovascular and Metabolic diseases, Heidelberg University Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Mannheim, Germany.

出版信息

Eur J Gen Pract. 2024 Dec;30(1):2413123. doi: 10.1080/13814788.2024.2413123. Epub 2024 Oct 28.

Abstract

BACKGROUND

Germany is challenged by an increasing shortage in general practice services, especially in non-urban areas. Task shifting from general practitioners (GPs) to other health professionals may improve practice efficiency to address this mismatch.

OBJECTIVES

Exploring GPs' motives and beliefs towards task shifting in non-urban Germany and identifying potential factors influencing these.

METHODS

The cross-sectional survey was disseminated by mail in three waves between July 2021 and August 2022 among all GPs in non-urban Baden-Wuerttemberg, Germany. It included items on demographics and practice characteristics as well as 15 Likert-scale items addressing motives and beliefs towards task shifting, based on the Theoretical Domain Framework. Likert-scale items were analysed descriptively, influencing factors on motives and beliefs were identified using multiple linear regression.

RESULTS

Response rate was 24.2% (281/1162), with respondents comparable in age and gender to all GPs in Baden-Wuerttemberg. GPs' motives and beliefs towards task shifting are positive overall. The majority expects task shifting to reduce their workload (87.9%) and increase practice efficiency (74.7%). They are open to shift additional tasks to other professionals (69.1%), even in the currently prohibited form of substitution (51.2%). Motives and beliefs were significantly more positive among younger GPs and those participating in the GP-centred care programme.

CONCLUSION

This study describes GPs' motives and beliefs towards task shifting in non-urban Germany. Identifying younger GPs and those participating in the GP-centred care programme as particularly endorsing may help design future interventions aiming to improve efficiency in general practice in non-urban Germany.

摘要

背景

德国正面临着全科医生服务日益短缺的挑战,尤其是在非城市地区。将任务从全科医生(GP)转移到其他卫生专业人员可能会提高实践效率,以解决这种不匹配的问题。

目的

探讨德国非城市地区全科医生对任务转移的动机和信念,并确定影响这些动机和信念的潜在因素。

方法

本横断面调查于 2021 年 7 月至 2022 年 8 月期间分三批通过邮件向德国巴登-符腾堡州非城市地区的所有全科医生发放。它包括人口统计学和实践特征的项目,以及基于理论领域框架的 15 个关于任务转移动机和信念的李克特量表项目。李克特量表项目进行描述性分析,使用多元线性回归确定对动机和信念有影响的因素。

结果

回应率为 24.2%(281/1162),受访者在年龄和性别方面与巴登-符腾堡州的所有全科医生相当。全科医生对任务转移的动机和信念总体上是积极的。大多数人希望任务转移能减轻他们的工作量(87.9%)并提高实践效率(74.7%)。他们愿意将其他任务转移给其他专业人员(69.1%),即使是以目前禁止的替代形式(51.2%)。年轻的全科医生和参与以全科医生为中心的护理项目的全科医生的动机和信念更为积极。

结论

本研究描述了德国非城市地区全科医生对任务转移的动机和信念。确定年轻的全科医生和参与以全科医生为中心的护理项目的全科医生特别支持可能有助于设计未来旨在提高德国非城市地区全科实践效率的干预措施。

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