Læknablaðið - 15.09.1984, Blaðsíða 52

236
LÆK.NABLAÐID
ingar um störf annarra heilbrigðisstétta en
lækna við heilsugæslu. Pví þrátt fyrir mikla
fjölgun hjúkrunarfræðinga og annars starfsliðs
er ekki að sjá að hlutdeild þeirra í störfum á
heilsugæslustöðvum hafi aukist að sama skapi.
Þess vegna er lagt til að í framhaldi af
þessari rannsókn verði gerð sérstök athugun á
störfum og verksviði hjúkrunarfræðinga,
meinatækna, ljósmæðra og annars starfsfólks
við heilsugæslustöðvar. Pegar slíkar niðurstöð-
ur ásamt upplýsingum um samskipti sjúklinga
og heilsugæslu liggja fyrir, ættu að vera til
staðar betri forsendur fyrir skipulegri stjórn á
heilsugæslu en verið hefur til pessa.
SUMMARY
This article describes the results of a follow up study
of primary health services in rural Iceland during
one week in October 1981. The former study, which
was conducted in September 1974, was the first
major study of medical services outside hospitals in
Iceland.
The aims of the study were: (a) To collect data on
primary health services; and (b) To compare the
results with the study from 1974. For this, certain
information was collected on health center-patient
contacts and on the working hours of doctors.
Data from 58 doctors and other personnel in 31
health centers are included in the analysis. The
information recorded included the main reason for
contact and the actions taken. Information on the
working hours of each doctor and on the allocation
of time to the various tasks was requested; 48 of the
58 doctors provided satisfactory information on this
subject.
The annual average number of contacts with the
health centers was estimated 4,9 per inhabitant (the
median was 4,8). However, the average number of
contacts varied considerly from one health district
to another. In most health centers with two or more
doctors the average number was between 4,0 and
6,0 patient/provider contacts per year. In 1974 the
annual average number of contacts was 4,6 per
inhabitant (the median was 4,5). The average num-
ber of inhabitants served by each doctor was 1303
ranging from 674 to 2051.
The most common reasons for contact with the
health centers were preventive measures (13,3 %),
respiratory diseases (11,4%), and diseases of the
bones and the organs of movement (9,1 %). In 1974
the proportion of preventive measures was only
4,6 % but the increase was mostly due to the fact
that health screenings in schools were carried out in
many districts at the time of study in 1981.
The recorded action taken could be one or more
in each case. The most common action was a
prescription (41,4 %), followed by an advice
(32,0 %), a minor examination (24,1 %). In 1974 the
figures for these actions were: a prescription 60,0 %,
next an advice 31,7 %, a minor examination 22,2 %,
and a clinical examination 17,7 %.
Referalls to specialists measured as the percenta-
ge of all contacts were 2,8 % in 1981 but 3,1 % in
1974. Referalls to hospitals and other health institu-
tions were also less frequent in 1981 than in 1974;
1,7 % respective 2,3 % of all contacts.
The average working hours per doctor were
nearly 50 per week in addition to hospital duties,
which were carried out by over half of the doctors.
Some general conclusions about primary health
services in Iceland are presented an discussed.
HEIMILDIR
1) Helgi Þ. Valdimarsson, Jón G. Stefánsson,
Guðrún Agnarsdóttir: »Læknisstörf í héraði«.
Læknablaðið, 1. tbl. 55 árg., Reykjavík 1969.
2) Gunnar Guðmundsson: »Könnun á sjúkdóma-
tíðni 1 Djúpavogslæknishéraði«. Læknablaðið,
1.-2. tbl. 63. árg., Reykjavík 1977.
3) Björn Önundarson: »Drög að könnun á störfum
9 heimilislækna í Reykjavik«. Læknablaðið, 3.-4.
tbl. 60. árg., Reykjavík 1974.
4) Guðjón Magnússon, Ólafur Sveinsson: »Könn-
un á læknispjónustu í Skagafirði«. Læknablað-
ið, 10.-12. tbl. 62. árg., Reykjavík 1976.
5) Guðmundur Sigurðsson, Guðjón Magnússon,
Helgi Sigvaldason, Hrafn Tulinius, Ingimar
Einarsson, Ólafur Ólafsson: Egilsstaðarann-
sóknin. Fylgirit við Heilbrigðisskýrslur. Land-
læknisembættið, Reykjavík 1980.
6) Helgi Sigvaldason, Ingimar Einarsson, Ottó
Björnsson, Ólafur Ólafsson, Sigmundur Sigfús-
son, Þórunn Klemenzdóttir: Könnun á lækn-
isþjónustu á landsbuggðinni 16.-22. september
1974. Fylgirit við Heilbrigðisskýrslur. Land-
læknisembættið, Reykjavík 1978.
7) Sigmundur Sigfússon: »Hlutur geðsjúkra í heil-
brigðisþjónustu annarri en geðlæknisþjónustu«.
Læknablaðið, 2. tbl. 67. árg., Reykjavík 1981.
8) Hagtíðindi, Nr. 1. 67. árg., Hagstofa íslands,
Reykjavík 1982, bls. 22-23.
9) Tölur frá Egilsstöðum.
10) Tölur frá Þjóðhagsstofnun.
11) Heilbrigðisskýrslur. Landlæknisembættið,
Reykjavík.
12) Nordisk Lakemedelsstatistik 1978-1980. Part I,
NLN Pub. Nr. 8, Nordiska lákemedelsnámnden,
Uppsala, Sverige 1982.
13) Helsestatistikk i de nordiske land 1981. Pub. Nr.
18, NOMESKO, Kobenhavn 1983.
14) Upplýsingar frá Ingibjörgu R. Magnúsdóttur,
deildarstjóra í Heilbrigðisráðuneytinu.