初级保健医生应该是协调员,而不是守门员
T Bodenheimer1, B Lo, L Casalino
1Department of Family and Community Medicine, University of California at San Francisco School of Medicine, USA.
JAMA
|June 8, 1999
概括
初级保健医生 (PCP) 应该从守门员转变为护理协调员. 这种新模式整合了初级和专科护理,以提高患者的结果和质量,超越了降低成本的目标.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学经济学 医学经济学
- 主要护理医学 医疗保健
背景情况:
- 目前的初级保健守门模式,专注于限制专家推以降低成本,不足以实现最佳的医疗实践.
- 不协调的专家开放访问的替代方案也存在重大缺点.
研究的目的:
- 建议修订初级保健模式,医生作为护理协调员而不是守门员.
- 概述医生工作流程,推流程和支付结构的必要变化,以支持这种新模式.
主要方法:
- 作为护理协调员的初级保健医生 (PCP) 的概念模型开发.
- 讨论必要的系统变化,包括转介授权,支付激励和专业预算.
主要成果:
- 拟议的模式取消了专家推的强制性PCP或托管护理组织授权.
- 它建议为PCP提供财政激励,以管理复杂的案件并优化专家转诊.
- 建议进行专业预算,以便在关门人移除后管理成本.
结论:
- 将PCP转变为护理协调员可以改善初级和专科护理的整合,提高整体质量.
- 试点项目对于测试和完善PCP作为护理协调员模型至关重要.
相关概念视频
Introduction To Health Care Delivery System
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
Specialized Care Centers and Settings-II
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Interdisciplinary Care: The Health Care Team-I
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution itself.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution itself.
Interdisciplinary Care: The Health Care Team-II
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care. Here are a few more healthcare professionals.
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
Nurses' Legal Responsibilities II
Establishing a secure, collaborative nurse-patient relationship is crucial for delivering high-quality care. This relationship, founded on trust, respect, and honesty, enhances the patient's comfort and willingness to share vital health information. For example, a nurse who listens actively and without judgment provides clear information about health conditions and treatment options and respects patient decisions, which builds a trusting relationship.
Communication between nurses and patients...
Communication between nurses and patients...
Accountability and Responsibility of a Nurse II
Professional accountability in nursing is a multifaceted concept that encompasses professional ethics, legal standards, and employment expectations. This framework ensures that nurses maintain and elevate the quality of care while upholding the values of their profession. It compels them to treat patients, families, and colleagues with respect, compassion, and integrity.
For example, a nurse demonstrating respect and compassion might listen attentively to a patient's concerns, provide comfort...
For example, a nurse demonstrating respect and compassion might listen attentively to a patient's concerns, provide comfort...
