了解和应对加拿大初级保健的不断变化的行政工作量:混合方法研究的协议
M Ruth Lavergne1,2, Catherine Moravac3, Fiona Bergin4
1Department of Family Medicine, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada ruth.lavergne@dal.ca.
BMJ open
|December 12, 2023
概括
尽管加拿大有更多的提供者,但加拿大初级保健服务的准入正在下降,原因是行政负担增加和服务责任转移. 本研究研究了这些因素,以寻找改善初级保健可及性的解决方案.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理医学 医疗保健
- 卫生政策分析 卫生政策分析
背景情况:
- 加拿大人面临着获得初级保健的挑战,这与初级保健提供者的高压力水平相吻合.
- 人均增长的初级保健提供者供应与服务可用性的下降形成鲜明对比,这表明存在关键差距.
- 增加的行政责任和初级保健团队承担住院服务可能会导致访问减少.
研究的目的:
- 量化新斯科舍省和新不伦瑞克省需要初级保健协调的服务量变化.
- 质量地探索初级保健提供者和工作人员的行政工作量是如何演变的.
- 通过与利益相关者进行深思熟虑的对话,确定关键问题并制定实际策略.
主要方法:
- 混合方法方法结合了定量行政数据分析 (2001/2002-2021/2022) 和定性访谈.
- 分析服务使用数据 (计数,人均费率,提供者,服务).
- 与家庭医生,执业护士和行政人员的采访进行反思性的专题分析,随后进行深入的对话活动.
主要成果:
- 定量分析将揭示服务需求的变化,影响初级保健工作量.
- 定性分析将提供有关初级保健提供者在行政变更方面的生活经验的见解.
- 审议对话将综合调查结果,提出可行的解决方案,以提高初级保健服务的获取和提供者福祉.
结论:
- 了解初级保健服务和行政需求的不断变化的性质对于解决接入问题至关重要.
- 确定和实施实用策略对于支持初级保健提供者和改善患者获取服务至关重要.
- 这项研究旨在为加拿大的更可持续和更容易获得的初级保健系统提供政策和实践的信息.
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