初级保健提供者与工作人员之间的关联报告了访问管理挑战和患者对访问访问的看法
Danielle E Rose1, Lucinda B Leung2,3, Michael McClean2
1VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. Danielle.Rose@va.gov.
面临更多访问管理挑战的初级保健诊所报告了更糟糕的患者体验. 改善呼叫中心沟通可能会提高患者获得及时预约和信息的机会.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理医学 医疗保健
- 患者获取研究 患者获取研究
背景情况:
- 优化患者获得初级保健是医疗保健提供的一个重大挑战.
- 诊所内的访问管理流程可以直接影响患者的体验和结果.
研究的目的:
- 评估初级保健准入管理挑战与患者报告的准入结果之间的关系.
- 确定与患者获得护理的机会较差相关的临床层面的具体挑战.
主要方法:
- 使用国家初级保健人员调查 (NPCPS) 和以患者为中心的医疗家庭 (SHEP-PCMH) 的医疗保健经验调查进行的横截面研究.
- 链接初级保健提供者 (PCP) 和工作人员对获得挑战的评价,以了解退伍军人患者对获得护理的看法.
- 采用多层次,多变量后勤回归,控制患者,设施和区域特征.
主要成果:
- 具有更高访问管理挑战的诊所 (前25%) 显示患者获得及时紧急预约 (AOR:0.86) 和常规预约 (AOR:0.74) 的几率明显较低.
- 这些诊所的患者也更少可能在同一天或第二天收到电话问题答案 (AOR:0.79).
- 研究人员发现,增加准入管理困难与患者对护理准入的看法下降之间存在着强烈的联系.
结论:
- 在初级保健中,更高水平的访问管理挑战与患者报告的更差的访问结果直接相关.
- 针对特定的访问管理问题,如呼叫中心通信,为增强患者体验提供了一个可行的策略.
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