垂直整合对中国医疗保健系统的影响:系统性审查和元分析
Xin Wang1, Enming Yang2,3, Caiyun Zheng1
1School of public health, Sun Yat-Sen University, No. 74 Zhongshan 2nd Road, Guangzhou 510080, China.
Health policy and planning
|September 28, 2023
概括
在中国的垂直整合.
科学领域:
- 医疗保健管理的管理
- 医疗保健服务研究 医疗服务研究
- 公共卫生政策 公共卫生政策
背景情况:
- 垂直整合是一种提高医疗保健系统绩效的策略.
- 关于其有效性的证据,特别是在发展中国家,是有限的和不一致的.
- 中国于2009年启动的医疗保健改革为研究垂直整合提供了一个背景.
研究的目的:
- 系统地审查垂直整合对中国医疗保健系统的影响.
- 综合来自各种研究设计的关于效率,质量和患者/提供者结果的证据.
主要方法:
- 在多个数据库 (PubMed,Embase等) 的系统文献搜索. 从2009年4月到2021年5月.
- 包括随机对照试验 (RCT),对照前后 (CBA) 试验,队列研究和中断时间序列 (ITS) 试验.
- 分析了47项涉及初级卫生机构和二级/三级医院的研究.
主要成果:
- 在大多数研究中,叙事综合表明了效率,护理质量和以提供者/患者为中心的结果的改善.
- 分析结果显示,高血压患者的血压显著降低,糖尿病患者的血糖控制 (HbA1c,禁食,食后) 得到改善.
- 对于高血压和糖尿病患者来说,治疗遵从性得到改善.
结论:
- 中国的垂直整合显示出改善医疗保健系统效率,护理质量和患者结果的潜力.
- 需要进一步的高质量的原始研究来加强证据基础.
- 调查结果表明,垂直整合是中国医疗保健环境中一个有前途的战略.
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