医生的最佳分配改善了中风护理中的可访问性和工作负载差异
Kazuki Ohashi1, Toshiya Osanai2, Kyohei Bando3
1Faculty of Health Sciences, Hokkaido University, N12-W5, Kita-ku, Sapporo, 060-0812, Japan.
International journal for equity in health
|November 8, 2023
概括
使用优化模型重新分配神经内血管专家显著减少了中风护理准入和医生工作量方面的差异. 这种方法提高了空间可访问性,并平衡了日本各地的医生需求,促进了医疗保健公平.
科学领域:
- 医疗保健管理的管理
- 医学经济学 医学经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 解决在中风护理和医生工作量方面存在的不平等问题至关重要.
- 目前的差异可能源于相对于患者需求的医生分配不足.
研究的目的:
- 分析优化模型是否可以减少空间访问差异和神经内血管专家的过度工作负载.
- 改善日本中风护理资源的公平分配.
主要方法:
- 使用双步浮动流域 (2SFCA) 和倒置的2SFCA方法来评估空间可访问性和工作量 (拥挤指数).
- 采用二次编程来优化神经内血管专家的重新分配.
- 针对日本的神经内血管专家和初级中风中心.
主要成果:
- 优化减少了空间可访问性的差异,需求加权指数的标准偏差 (SD) 从125.625降至97.625.5.
- 权重中位空间可访问性指数有所改善,从2.811增加到3.929.
- 潜在拥挤指数的SD (工作负载差异) 从10,040.36下降到5934.275,由灵敏度分析证实.
结论:
- 神经内血管专家的重新分配有效地减少了医疗保健获取和工作量方面的区域差异.
- 调查结果支持卫生政策规划,以实现医疗保健系统中更大的公平.
- 优化模型为平衡专家分布和患者获得中风护理提供了一个可行的策略.
相关概念视频
Atherosclerosis IV: Nursing Management
17
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
17
Acute Coronary Syndrome IV: Interprofessional Care
11
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
11
Peripheral Artery Disease III: Interprofessional Care
11
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
11
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Methods of Documentation VI: Case Management Model
576
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
576
Angina V: Nursing Management
18
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
18


