在维多利亚州公共口腔卫生部门开发和实施基于价值的医疗保健框架的经验和经验
Shalika Hegde1, Susan McKee1, Deborah Cole2
1Dental Health Services Victoria, Melbourne, Vic., Australia.
概括
在公共牙科服务中实施基于价值的医疗保健 (VBHC) 提高了患者的护理和效率. 这种共同设计的框架导致错过预约减少,预防性干预增加,改变了牙科服务的提供.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 牙科公共卫生 牙科公共卫生
- 医疗保健管理的管理
背景情况:
- 基于价值的医疗保健 (VBHC) 是一个新兴的模式,专注于患者的结果和价值.
- 在公共牙科服务中实施VBHC为系统转型带来了独特的挑战和机会.
- 共同设计方法对于将患者和员工的观点整合到医疗保健重新设计中至关重要.
研究的目的:
- 描述在维多利亚州公共牙科部门共同设计的VBHC框架的开发和实施.
- 评估VBHC实施对服务提供,患者结果和劳动力利用的影响.
- 确定公共牙科环境中VBHC采用的关键促进者和障碍.
主要方法:
- 一个混合方法研究,利用探索性定性设计和参与性行动研究.
- 基于经验的共同设计,涉及患者,员工和利益相关者,以开发和完善服务.
- 通过在线患者管理系统收集定量数据,包括患者报告的结果指标 (PROM) 和患者报告的经验指标 (PREM).
主要成果:
- 实施VBHC需要密集的共同设计,协作和服务规划,以患者需求为重点.
- 观察到显著的改善:缺席率下降了44%,预防干预增加了60%.
- 劳动力重组导致80%的服务转移到相关卫生专业人员,提高了牙医处理复杂病例的能力.
- 报告的患者满意度很高,在护理满足需求,清晰度,参与度和感觉得到照顾方面达成87-94%的同意.
结论:
- 实施VBHC为改变公共牙科卫生系统提供了巨大的潜力.
- 成功的VBHC采用需要一个全面的方法,超越组织变革,包括政策和实践.
- 维持整个医疗保健系统的VBHC原则对于长期影响和改善患者价值至关重要.
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