北京市城区全科医生工作内容的非参与观察研究

摘要

Objective:To investigate the working contents of General Practitioners (GPs) and existing problems in the urban area of Beijing.Methods:Six GPs in community health service institutions were selected by purposive sampling.Consecutive consultations and public health and administrative workload of the GPs were observed via non-participant observation.Results:Among the 1135 consultations,the most frequent complaint was prescription refill of chronic diseases (66.0％),followed by blood pressure measurement (8.8％),counseling (7.8％),cough (7.2％),measuring blood sugar (4.6％) etc.The most frequent consultation content was prescription (81.0％),followed by medication instruction (30.0％),history taking (27.0％),explanation of disease (21.9％),blood pressure measurement (19.6％) etc.The GPs were responsible for partial public health and administrative work,including health record related work (60 times),screening of stroke (60 times),pharmacy related work (27 times) etc.Conclusion:The consultation of the GPs did not embody the value of general practice.GPs' positioning should be better defined in the future to promote the quality of care.%目的:了解北京市城区全科医生的工作内容及存在的问题.方法:通过目的抽样,选取在社区卫生服务机构工作的6名全科医生.采用非参与观察法,观察全科医生的诊疗过程,以及观察期间全科医生承担的公共卫生和管理性工作情况.结果:在全科医生接诊的1135名患者中,最常见的主诉是慢性疾病取药(66.0％),其次为测量血压(8.8％)、咨询(7.8％)、咳嗽(7.2％)、查血糖(4.6％)等.全科医生最多的诊疗内容是开药(81.0％),其次是用药指导(30.0％)、问病史(27.0％)、解释病情(21.9％)和测量血压(19.6％)等.全科医生承担了较多公共卫生和管理性工作,包括健康档案相关工作(60次)、卒中筛查工作(60次)、药房相关工作(27次)等.结论:全科医生在诊疗中没有较好的体现全科医学的价值,应进一步明确全科医生的功能定位,提高全科医生的诊疗质量.