50岁以上的瑞士居民的护理连续性:使用索赔数据进行纵向研究
Anna Nicolet1,2, Isabelle Peytremann-Bridevaux2,3, Joël Wagner4,5
1Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland.
Integrated healthcare journal
|July 13, 2023
概括
瑞士的护理连续性 (COC) 测量显示,初级保健连续性很高,但总体连续性根据所选择的指数和时间范围而有很大差异. 了解这些差异对于有效监测医疗保健质量至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
- 医疗保健管理的管理
背景情况:
- 护理连续性 (COC) 对医疗保健质量和综合护理至关重要,但测量缺乏标准化.
- 常规收集用于COC测量的数据是常见的,但对指标和时间框架缺乏共识.
- 在像瑞士这样的碎片化系统中,评估COC尤其重要.
研究的目的:
- 为了比较各种护理连续性指数 (COCIs) 和测量50岁以上瑞士居民的COC的时间范围.
- 评估不同的指数和时间框架如何影响COC在现实世界医疗保健环境中的评估.
主要方法:
- 使用了50岁及以上瑞士居民的保险索赔数据.
- 计算并比较基于多次访问的COCIs (Bice-Boxerman,通常的护理提供者,Herfindahl-Hirschman,修改的连续性指数),使用所有医生访问和初级保健 (PC) 访问.
- 分析了短期 (1年) 和中期 (4年) 时间的指数.
主要成果:
- 所有访问的平均指数从0.51到0.77不等;PC指数的变化较小,中位数为1.00.
- 衡量提供商多样性的指数随着时间的延长而下降,而那些关注访问/提供商数量的指数则增加.
- 根据所选择的指数和时间框架,观察到COCI解释的显著差异.
结论:
- 瑞士的整体COC适度低,但在国际上可比;PC的COC始终很高.
- 选择特定的COC指数和时间视界显著影响解释和发现.
- 选择适当的指数和时间框架对于准确的COC监测和医疗保健质量评估至关重要.
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