在内部医学教师中使用初级保健例外的驱动因素的定性研究
Roshni Patel1, Timothy J Marquis1, Aliza Cook2
1Yale University School of Medicine, New Haven, CT, USA.
Journal of general internal medicine
|September 12, 2023
概括
在医生看病的医生.
科学领域:
- 医学教育 医学教育
- 医疗保健政策 医疗保健政策
- 临床实践管理 临床实践管理
背景情况:
- 初级保健例外 (PCE) 是医疗保险和医疗补助服务中心 (CMS) 的计费规则.
- 它允许监督医生在没有直接监督的情况下为居民提供的门诊护理收费.
- 委托越来越多地用于评估对无监督实践的准备.
研究的目的:
- 探索影响护理医生在门诊环境中使用PCE的因素.
- 确定使用PCE的教师教师的动机.
主要方法:
- 定性探索性研究的设计.
- 一对一的半结构化访谈与27个内科医学院的教师.
- 使用接地理论原则进行主题分析.
主要成果:
- 四个关键主题影响了PCE的使用:临床环境,照顾态度,居民特征和患者属性.
- 出席医生的"内部规则"经常导致不使用PCE.
- 通过PCE促进居民自治和通过放弃它来确保安全之间存在冲突.
结论:
- PCE可以增强居民的自主性,信心和临床效率.
- 关于PCE使用的参与决策涉及多种因素的复杂平衡.
- 需要进行标准化的能力评估,以减轻PCE决策中的偏见.
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