单手与多手的一般实践:英格兰质量结果的横截面研究
Ian Holdroyd1, William Chadwick1, Adam Harvey-Sullivan2
1Foundation Doctor, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
在英格兰,单人通用诊所提供更高的患者满意度和护理连续性. 然而,它们在糖尿病管理和癌症检测等临床结果方面表现略低,与较大,多人手的实践相比.
科学领域:
- 一般实践和初级保健服务.
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
背景情况:
- 转向大群体实践的转变引发了各种护理模式的有效性和可持续性的问题.
- 了解单手和多手通用诊所之间的绩效差异对于优化英格兰的初级保健服务至关重要.
研究的目的:
- 为了比较英格兰单手通用实践与多手实践的表现.
- 评估不同实践结构的患者体验,临床结果和紧急服务利用情况.
主要方法:
- 一项对英格兰一般诊所的比较研究,涉及1000多名患者.
- 使用劳动力数据将实践分类为单人或多人.
- 分析患者调查得分,糖尿病和高血压结果,急诊室陈述和癌症检测率,使用通用线性模型.
主要成果:
- 单人诊所,通常在贫困地区,报告了更高的患者满意度,访问和连续性.
- 在单人实践中,糖尿病管理和癌症检测率略低一些.
- 在单人实践中,急诊室的表现较高,但在控制实践的乡村和规模时,这种关联减少了.
结论:
- 单人实践在患者报告的满意度和连续性方面表现出色.
- 需要进一步研究实践规模和多学科团队对患者结果和经验的影响.
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