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プライマリケアにおける研究の必要性
Jan M De Maeseneer1, Mieke L van Driel, Larry A Green
1Department of General Practice and Primary Health Care, Ghent University, Ghent, Belgium. jan.demaeseneer@ugent.be
Lancet (London, England)
|October 25, 2003
まとめ
医療におけるエビデンスと実践のギャップを埋めるには,単なる研究結果以上のものが必要です. 医療の質の向上には,医療,文脈,政策の証拠を統合することが必要であり,特に初等医療施設ではそうである.
科学分野:
- 医療サービス 研究 医療サービス
- プライマリーケア医療 プライマリーケア医療
- 証拠に基づいた実践
背景:
- 科学的証拠を臨床的実践に翻訳することは,歴史的に医療の質を向上させることを目的としてきましたが,この目標はほとんど達成されていません.
- 医療品質の概念は多面的で,効果的な改善のために医療,文脈,および政策に関連する証拠の合成を要求します.
研究 の 目的:
- 科学的証拠を臨床実践に翻訳する際の複雑さを調査し,医療の質を改善するための重要な分野を特定する.
- プライマリケア集団のユニークな側面,疾患の表れ,そして重要な医師と患者の相互作用を考慮する研究の必要性を強調する.
主な方法:
- 本研究は,医療におけるエビデンス翻訳と品質改善に関する既存の文献と理論的枠組みをまとめています.
- それは,さまざまな種類の証拠と研究方法論を統合した包括的なアプローチの必要性を強調しています.
主要な成果:
- 科学的証拠を臨床実践に直接翻訳することは,期待されたように,医療の質を一貫して改善していない.
- 品質改善イニシアチブは,医療,文脈 (例えば,医師と患者のダイナミクス),および政策要因を含むより広範なエビデンスベースを必要とします.
- プライマリーケアの研究は,集団特有の特徴と疾患の流行率を扱わなければならない.
結論:
- 医療の質の向上には,医療,文脈,政策の証拠を統合した総合的なアプローチが必要である.
- ファミリー・プラクティスの知識基盤の拡大は,エビデンス・プラクティスのギャップを効果的に埋めるために,複数の理解方法を組み込むことを必要とします.
- 政策レベルでの公平性の問題への対処は,公正な医療の質の改善に不可欠です.
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