在负责任的护理组织中,对照护理协调资源的位置选择的权衡
Health care management review
|August 24, 2023
概括
将护理协调员集中到负责任的护理组织 (ACO) 中,可以改善信息共享,同时将其嵌入到实践中,可以提高护理质量. 这些发现凸显了为有复杂需求的医疗补助患者组织护理协调资源的权衡.
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
- 负责的护理组织 负责的护理组织
背景情况:
- 对负责任的护理组织 (ACO) 来说,护理协调至关重要,特别是在医疗补助计划中,为有复杂需求的患者提供服务.
- 在这种情况下,对护理协调资源的最佳组织,包括集中与分散,仍然没有得到充分的研究.
研究的目的:
- 检查护理协调员的位置,管理和配套与护理质量和协调结果之间的关系.
- 在Medicaid ACOs中为组织护理协调资源的策略提供信息.
主要方法:
- 对来自17个马萨诸塞州医疗补助局 (Medicaid ACOs) 的225个实践场所的调查数据进行横截面分析.
- 使用受控的集群强度回归来评估护理协调员安排与关键结果之间的关联.
- 结果包括临床信息共享,护理质量的提高,社会服务推知识和跨资源协调.
主要成果:
- 在ACO总部集中护理协调员与信息共享的增加有关.
- 在实践场所内嵌入护理协调员与更大的护理质量改善有关.
- 在外部组织内嵌协调员显示信息共享和护理质量下降.
结论:
- 护理协调员的物理位置和管理结构对ACO的业绩产生重大影响.
- 负责任的护理组织可能需要平衡信息流动的集中资源与用于改善护理质量的嵌入资源.
- 关于护理协调员安置的战略决策涉及不同绩效指标之间的权衡.
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