在一般实践中,用于管理同一天咨询请求的电话分类 (ESTEEM试验):一个集群随机对照试验和成本后果分析
John L Campbell1, Emily Fletcher1, Nicky Britten2
1Primary Care Research Group, University of Exeter Medical School, Exeter, UK.
Lancet (London, England)
|August 8, 2014
概括
一般医生 (GPs) 或护士的电话分选增加了初级保健联系人分别为33%和48%,成本与通常护理相似. 这种方法可能有助于提供初级保健,但需要对整个系统进行评估.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
- 卫生技术评估 卫生技术评估
背景情况:
- 在初级保健中支持电话分拣的证据有限.
- 电话分拣越来越多地用于管理初级保健工作量.
- 这项研究评估了全科医生和护士领导的电话分拣的有效性和成本.
研究的目的:
- 评估由全科医生和护士领导的电话分拣的有效性.
- 为了确定与常规护理相比,电话分拣的成本后果.
- 在同一天的咨询请求后评估初级保健工作量.
主要方法:
- 实用性,集群随机对照试验和经济评估进行.
- 42个英国实践被随机分为GP选,护士选或常规护理.
- 主要结局是28天的初级保健工作量 (患者接触).
主要成果:
- 与常规护理相比,全科医生选增加了33%的接触者 (RR 1.33) 和48%的护士选 (RR 1.48).
- 在这三个组之间,在28天的估计成本中没有显著差异.
- 7天内死亡与试验组或程序无关.
结论:
- 一般医生或护士的电话分组增加了初级保健联系人.
- 与电话分拣相关的成本与通常的护理相似.
- 电话分组可能会支持初级保健服务,但需要考虑整个系统的影响.
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