初级保健访问长度与门诊利用,连续性和护理流程的关联
David T Liss1, Andrew J Cooper1, Manisha Cherupally1
1Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
较短的初级保健医生 (PCP) 访问 (15/30分钟) 增加了患者的初级保健使用,但减少了专科护理的使用. 这些访问长度模式在种族/族群之间产生了不同的影响.
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
- 卫生经济学 卫生经济学
背景情况:
- 了解初级保健访问时间对医疗保健利用的影响是有限的.
- 预定预约时间的变化可能会影响患者的访问和护理模式.
研究的目的:
- 评估初级保健医生 (PCP) 访问长度模板和PCP/患者特征之间的关联.
- 评估PCP访问长度和门诊利用率之间的关系,包括初级和专科护理.
- 检查对接受预防性护理和护理连续性的影响.
主要方法:
- 追溯性队列研究利用来自美国大型学术卫生系统的数据.
- 初级保健医生 (PCP) 访问长度模板被分类为15/30分钟或20/40分钟的预约.
- 患者级分析包括238,806名患者和222名PCP,经过调整的统计建模.
主要成果:
- 使用15/30分钟模板的PCP比使用20/40分钟模板的PCP有更多的初级保健访问 (IRR1.09) 和更少的专科护理访问 (IRR0.92).
- 在产科/妇科诊所,护理连续性或预防性护理接收方面没有发现显著差异.
- 较短的访问模板与非西班牙裔白人患者的初级保健访问增加有关,但与非西班牙裔黑人患者的初级保健访问不相关.
结论:
- 初级保健医生 (PCP) 访问的安排时间长度会影响患者使用专科护理.
- 访问长度对初级保健使用的影响在不同种族和种族群体之间有所不同.
- 这些发现凸显了在卫生系统设计和公平性考虑中考虑访问安排的必要性.
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