第一次接触物理治疗:临床有效性和成本的评估
Nicola E Walsh1, Serena Halls1, Rachel Thomas1
1Centre for Health and Clinical Research, University of the West of England, Bristol, UK.
概括
第一接触物理治疗从业者 (FCPPs) 提供安全有效的肌肉骨疾病护理,与全科医生 (GP) 领导的服务相比,显示成本效益和减少阿片类药物处方.
科学领域:
- 肌肉骨健康 肌肉骨健康
- 主要护理实践的初级护理实践
- 卫生经济学 卫生经济学
背景情况:
- 第一次接触物理治疗从业者 (FCPPs) 被整合到一般实践中,以独立于GP推来管理肌肉骨疾病 (MSKDs).
- 该模型旨在为患有MSKD的患者提供专家评估,诊断和治疗计划.
研究的目的:
- 评估FCPP主导的护理模型与传统的GP主导的护理的临床有效性.
- 为了比较FCPP和GP模型之间的相关医疗保健成本.
主要方法:
- 一个多站点的案例研究设计被采用在英国的一般实践.
- 三种护理模式进行了比较:全科医生主导的护理,标准范围的FCPP (FCPP-St) 和附加处方/注射资格的FCPP (FCPP-AQ).
- 426名参与者在6个月内跟踪了患者结果 (SF-36 PCS) 和医疗保健使用情况.
主要成果:
- 在6个月后,在三个模型之间没有观察到身体功能 (SF-36 PCS) 的显著差异.
- 与医生主导的护理 (54.7%) 相比,FCPP模型显示,3个月后改善的患者比例更高 (FCPP-St: 72.4%,FCPP-AQ: 66.4%).
- FCPP模型显示,NHS成本显著降低 (FCPP-St:£41.0,FCPP-AQ:£44.0) 与GP领导的护理 (£105.5) 相比,药物处方减少,包括阿片类药物.
结论:
- 以FCPP为主导的护理模式对于管理肌肉骨疾病的患者来说是安全和临床有效的.
- 这些模型为NHS提供了显著的成本优势.
- FCPP的整合导致阿片类药物处方减少,有助于更安全的疼痛管理策略.
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