神经学农村接入模型的运营影响:反思需求塑造的重要性
Alexis Kurek1, Kennedy Boone-Sautter1, Cynthia M Hingtgen1
1Population Health (AK, KB-S), Corewell Health West; and Neurological Health (CMH, AA), Corewell Health West Grand Rapids, MI.
一个新的区域神经病诊所增加了转诊,但并没有减少主要中心诊所看到的患者的复杂性. 这种枢纽式模型需要仔细的需求管理,以改善获得专业神经病治疗的机会.
科学领域:
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
- 医疗保健操作 医疗保健操作
背景情况:
- 随着对神经专业护理需求的不断增长,医疗系统面临着劳动力短缺的压力.
- 研究创新的护理提供模式对于满足患者需求至关重要.
- 探索了一个带有先进实践提供商 (APP) 和远程医生监督的集线模型.
研究的目的:
- 评估一个由APPs配备的区域神经病诊所的运营影响.
- 为了评估一个中枢和分支模型在服务较低复杂度的患者的有效性.
- 分析转诊量,患者复杂性和访问指标的变化.
主要方法:
- 追溯性,横截面的研究设计.
- 分析转诊量,取消/没有出现率和患者复杂性.
- 在建立区域诊所之前和之后对指标的纵向评估.
- 在区域诊所看病的患者与初级神经病学实践的比较.
主要成果:
- 来自目标农村县的转诊量在诊所开业后显著增加.
- 区域诊所主要服务于较低复杂度的患者.
- 在初级诊所的低复杂性患者总体体积没有减少.
- 取消和没有出现率不受影响.
结论:
- 区域诊所产生了大量的转诊量,超过了其容量,增加了中心诊所的负载.
- 该模型并没有像预期的那样改善高复杂性患者的访问.
- 需求塑造和适当的利用对于优化此类模型至关重要.
- 需要制定减轻过度需求和确保资源有效分配的战略.
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