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首页> 外文期刊>European journal of public health >Demand and supply for psychological help in general practice in different European countries: access to primary mental health care in six European countries.
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Demand and supply for psychological help in general practice in different European countries: access to primary mental health care in six European countries.

机译：欧洲不同国家在一般实践中对心理帮助的需求和供应：六个欧洲国家获得初级心理保健的机会。

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BACKGROUND: The general practitioner is usually the first health care contact for mental problems. The position of a general practitioner may vary between health care systems, depending on the referral system (gatekeepers versus directly accessible specialists), presence of fixed lists and the payment system. This may influence patients' expectations and requests for help and GPs' performance. In this paper the effects of working in different health care systems on demand and supply for psychological help were examined. METHODS: Data were collected in six European countries with different health care system characteristics (Belgium, Germany, The Netherlands, Spain, Switzerland and the UK). For 15 consecutive contacts with 190 GPs in the six countries, each patient completed questionnaires concerning reason for visit and expectations (before) and evaluation (after consultation). General practitioners completed registration forms on each consultation, indicating familiarity with the patient and diagnosis. General practitioners completed a general questionnaire about their personal and professional characteristics as well. RESULTS: Practices in different countries differed considerably in the proportion of psychological reasons for the visit by the patient and psychological diagnoses by the GP. Agreement between patients' self-rated problems and GPs' diagnoses also varied. Patients in different countries evaluated their GPs' psychological performance differently as well, but evaluation was not correlated with agreement between request for help and diagosis. In gatekeeping countries, patients had more psycho-social requests, GPs made more psychological diagnoses and agreement between both was relatively high. Evaluation, however, was more positive in non-gatekeeping countries. Individual characteristics of doctors and patients explained only a relatively small part of variance. CONCLUSIONS: Health care system characteristics do affect GPs' performance in psycho-social care.
机译：背景：全科医生通常是精神疾病的第一个医疗保健联系人。全科医生的位置在医疗保健系统之间可能会有所不同，具体取决于转诊系统（看门人与直接可访问的专家），固定清单的存在和支付系统。这可能会影响患者对治疗的期望和要求以及全科医生的表现。在本文中，研究了在不同卫生保健系统中工作对心理帮助的需求和供应的影响。方法：在六个具有不同医疗保健系统特征的欧洲国家（比利时，德国，荷兰，西班牙，瑞士和英国）收集了数据。对于六个国家中190名全科医生的15次连续接触，每位患者填写了有关就诊原因和期望（之前）和评估（咨询之后）的问卷。全科医生在每次会诊时都要填写注册表，表明对患者的熟悉程度和诊断。全科医生还完成了有关其个人和职业特征的一般问卷。结果：在不同国家，患者就诊的心理原因和全科医生的心理诊断所占比例差异很大。患者的自我评价问题与全科医生的诊断之间的一致性也各不相同。不同国家的患者对全科医生的心理表现也有不同的评估，但评估与求助与诊断之间的一致性并不相关。在看门国家中，患者有更多的社会心理要求，全科医生做出了更多的心理诊断，而且两者之间的共识较高。但是，在非关门国家中，评价更为积极。医生和患者的个人特征仅解释了相对较小的差异。结论：卫生保健系统的特征确实会影响全科医生在社会心理保健方面的表现。

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