基于价值的医疗保健是否支持以患者为中心的护理? 对证据进行范围审查
Martha Kidanemariam1, Arwen H Pieterse2, Dorine J van Staalduinen2,3
1Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands m.kidanemariam@lumc.nl.
BMJ open
|July 10, 2023
概括
基于价值的医疗保健 (VBHC) 实施通常使用以提供者为中心的措施,而不是以患者为中心的措施. 目前关于VBHC支持以患者为中心的护理的证据有限,这表明研究缺口.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 以患者为中心的护理
背景情况:
- 标准化结果措施是基于价值的医疗保健 (VBHC) 的关键.
- 这种标准化可能与以患者为中心的护理原则相冲突,该原则强调个性化.
- 在VBHC的目标和以患者为中心的护理之间存在潜在的紧张关系.
研究的目的:
- 提供用于评估VBHC实施影响的措施的概述.
- 检查现有证据表明VBHC支持以患者为中心的护理的程度.
- 确定VBHC结果测量和以患者为中心之间的潜在冲突.
主要方法:
- 根据乔安娜·布里格斯研究所的方法进行了范围审查.
- 在科克伦图书馆,EMBASE,MEDLINE和Web of Science数据库中进行了搜索.
- 包括和分析了2006年以后发表的评估VBHC实施效应的经验论文.
主要成果:
- 包括39项研究,包括94项独特措施.
- 过程指标,成本措施和临床结果是最常见的 (72项措施),但很少以患者为中心.
- 患者报告的结果和经验 (20项措施) 较少出现,但经常捕捉到以患者为中心的维度.
结论:
- 目前支持VBHC在以患者为中心的护理中的作用的证据有限,这突显了知识差距.
- 在VBHC研究中经常使用的措施优先考虑提供者,机构或付款人的观点,而不是以患者为中心.
- 需要进一步的研究,以使VBHC实施与以患者为中心的护理原则相协调.
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