澳大利亚住宅老年护理机构的课后远程医疗:混合方法评估
Steven A Trankle1, Jennifer Reath2
1Department of General Practice, School of Medicine, Western Sydney University, Building 30.3.18 Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia. s.trankle@westernsydney.edu.au.
BMC health services research
|November 16, 2023
概括
老年护理居民的远程医疗服务减少了医院转移,改善了设施内护理. 这种模式支持全科医生和住院老年护理机构的工作人员,增强及时住院治疗.
科学领域:
- 老年学是一门学科.
- 医疗保健服务研究 医疗服务研究
- 远程医疗远程医疗
背景情况:
- 澳大利亚的老年护理系统面临着压力,影响住院老年护理设施 (RACF) 和全科医生 (GP),特别是在工作时间后.
- 许多居民不必要地通过救护车转移到医院急诊室 (ED),以获得在RACF内可管理的护理.
- 一个为期12个月的MyEmergencyDoctor (MED) 计划利用ED医生在六个RACF中进行课后远程医疗.
研究的目的:
- 评估MyEmergencyDoctor (MED) 在住院老年护理设施的课后远程医疗服务的有效性和影响.
- 评估该服务对救护车使用,住院和对RACF工作人员和全科医生提供的支持的影响.
- 探索利益相关者的经验,并确定影响远程医疗模式可持续性和潜在扩展的因素.
主要方法:
- 来自MED,RACF和救护车服务的统计数据的描述性分析.
- 对一般医生,RACF工作人员,MED工作人员和居住家庭成员的采访数据进行主题分析.
- 利用NASSS (非采用,放弃,扩展,传播和可持续性) 框架进行数据合成和分析.
主要成果:
- 该MED服务成功地解决了大多数电话 (179/209) 的内部治疗,减少了救护车的使用和住院.
- 采访证实,MED为不需要住院的居民提供了及时的护理,并得到了技术,培训和快速访问的支持.
- RACF工作人员感到受到了支持,全科医生疲劳可能减少,该服务补充了现有的全科医生护理.
结论:
- 课后远程医疗模式有效地提供了内部护理,减少了救护车转移,并支持全科医生和RACF工作人员.
- 该服务是用户友好的,促进了良好的沟通,尽管一些全科医生更喜欢直接的护理.
- 可持续性需要支持性政策,为全科医生和社区护理提供资金,增加RACF人员,并可能扩大息护理和正常时间.
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