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首页> 外文期刊>BMC Family Practice >Are patients’ preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations
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Are patients’ preferences regarding the place of treatment heard and addressed at the point of referral: an exploratory study based on observations of GP-patient consultations

机译：在转诊时是否听到并解决了患者对治疗地点的偏好：一项基于全科医生与患者会诊的观察性研究

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Background Today, in several north-western European countries, patients are encouraged to choose, actively, a healthcare provider. However, patients often visit the provider that is recommended by their general practitioner (GP). The introduction of patient choice requires GPs to support patients to be involved, actively, in the choice of a healthcare provider. We aim to investigate whether policy on patient choice is reflected in practice, i.e. what the role of the patient is in their choices of healthcare providers at the point of referral and to what extent GPs’ and patients’ healthcare paths influence the role that patients play in the referral decision. Methods In 2007–2008, we videotaped Dutch GP-patient consultations. For this study, we selected, at random, 72 videotaped consultations between 72 patients and 39 GPs in which the patient was referred to a healthcare provider. These were analysed using an observation protocol developed by the researchers. Results The majority of the patients had little or no input into the choice of a healthcare provider at the point of referral by their GP. Their GPs did not support them in actively choosing a provider and the patients often agreed with the provider that the GP proposed. Patients who were referred for diagnostic purposes seem to have had even less input into their choice of a provider than patients who were referred for treatment. Conclusions We found that the GP chooses a healthcare provider on behalf of the patient in most consultations, even though policy on patient choice expects from patients that they choose, actively, a provider. On the one hand, this could indicate that the policy needs adjustments. On the other hand, adjustments may be needed to practice. For instance, GPs could help patients to make an active choice of provider. However, certain patients prefer to let their GP decide as their agent. Even then, GPs need to know patients’ preferences, because in a principal-agent relationship, it is necessary that the agent is fully informed about the principal’s preferences.
机译：背景技术今天，在一些西北北欧国家，鼓励患者积极选择医疗保健提供者。但是，患者通常会寻求其全科医生（GP）推荐的提供者。引入患者选择要求全科医生支持患者积极参与医疗保健提供者的选择。我们旨在调查患者选择的政策是否在实践中得到反映，即患者在转诊时在他们对医疗提供者的选择中扮演什么角色，以及全科医生和患者的医疗保健路径在多大程度上影响患者扮演的角色在推荐决定中。方法在2007–2008年，我们对荷兰全科医生进行了患者咨询。在本研究中，我们随机选择了72位患者和39位GP之间的72次录像咨询，其中将患者转介给医疗保健提供者。使用研究人员开发的观察方案对这些进行了分析。结果在全科医生转诊时，大多数患者很少或根本没有选择医疗服务提供者。他们的全科医生不支持他们积极选择提供者，患者通常会与全科医生提议的提供者达成一致。出于诊断目的而被转诊的患者似乎比被转诊的患者对提供者的选择甚至更少。结论我们发现，即使在患者选择政策上期望他们积极选择提供者的患者，在大多数会诊中，GP仍会代表患者选择医疗提供者。一方面，这可能表明该政策需要调整。另一方面，可能需要进行调整以进行练习。例如，全科医生可以帮助患者积极选择提供者。但是，某些患者倾向于让其GP决定其代理人。即使这样，全科医生也需要了解患者的偏好，因为在委托人与代理人的关系中，有必要向代理人充分了解委托人的偏好。

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