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A descriptive study of managed-care hassles in 26 practices

机译：描述性研究涉及26种实践中的医疗护理纠纷

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>Objectives To explore the nature of managed-care hassles in primary care physicians' offices and to determine the feasibility of practice-based research methods to study the problem. >Methods 16 internists and 10 family physicians volunteered to collect data about managed-care hassles during or shortly after the office visit for 15 consecutive patients using preprinted data cards. >Outcome measures Number of hassles, time required for hassles, and interference with quality of care and doctor-patient relationship. >Results Physicians adapted easily to using data cards. Before the pilot study, participants estimated a hassle rate of 10% and thought that interference with quality of care and the doctor-patient relationship was infrequent. Of 376 total visits for which the physicians completed data cards, 23% of visits generated 1 or more hassles. On average, a physician who saw 22 patients daily experienced 1 hassle lasting 10 minutes for every 4 to 5 patients. More than 40% of hassles were reported as interfering with quality of care, the doctor-patient relationship, or both. >Conclusions The high hassle rate, in addition to the interference of hassles with quality of care and the doctor-patient relationship, suggests the need for further investigation into managed-care hassles using practice-based research methods.
机译：>目标：探讨基层医疗医生办公室中管理式医疗麻烦的性质，并确定基于实践的研究方法来研究该问题的可行性。 >方法 16位内科医师和10位家庭医生自愿使用预印的数据卡在就诊期间或就诊后不久连续收集15名患者的有关管理医疗纠纷的数据。 >结果措施：麻烦数量，麻烦所需时间以及对护理质量和医患关系的干扰。 >结果：医师很容易适应使用数据卡的情况。在试验研究之前，参与者估计有10％的争吵率，并认为很少会干扰护理质量和医患关系。在医师完成数据卡的376次就诊中，有23％的就诊产生了1次或更多的麻烦。平均而言，每天看22位患者的医生每4至5位患者经历1次持续10分钟的麻烦。据报道，超过40％的麻烦干扰了护理质量，医患关系或两者兼而有之。 >结论：麻烦率高，除了会影响医疗质量和医患关系之外，还需要使用基于实践的研究方法进一步调查管理式麻烦。

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