程序理论来描述不同的全科医生服务模式如何在不同的环境中在紧急部门 (GP-ED) 或与之相邻的紧急部门 (GP-ED) 中工作:现实的评估
Alison Cooper1, Michelle Edwards2, Freya Davies2
1Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK CooperA8@cardiff.ac.uk.
Emergency medicine journal : EMJ
|April 22, 2024
概括
在急诊室 (ED) 的全科医生 (GP) 服务显示出不同的结果,患者流量或等待时间没有整体改善. 了解当地环境是优化这些复杂的GP-ED模型的关键.
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
- 紧急医疗 紧急医疗
背景情况:
- 英国NHS的目标是改善患者需求和急诊室 (ED) 的流量.
- 在2017年引入了与ED (GP-ED) 结合或结合的全科医生 (GP) 服务,并获得了大量资金.
- 目前的证据表明,需求管理或等待时间没有持续改善,服务模式有效性有显著差异.
研究的目的:
- 分析不同全科医生 (GP) 服务的有效性和运营变化,这些服务与急救部门 (ED) 结合或结合在一起.
- 开发程序理论,解释各种GP-ED服务模型如何以及为什么起作用,考虑上下文,机制和结果.
主要方法:
- 混合方法分析,结合定性 (观察,采访) 和定量 (时间序列) 数据.
- 使用现实主义方法来理解上下文-机制-结果配置.
- 针对英格兰和威尔士13个不同的GP-ED服务模式进行了有目的的抽样.
主要成果:
- 全科医生-ED模型表现出由个人,部门和外部因素影响的复杂性和可变性.
- 量化数据质量不一致;没有观察到出席人数或等待时间的总体减少.
- 程序理论揭示了集成,并行和外部GP-ED模型的不同操作模式,突出了不同的GP角色和集成水平.
结论:
- 在急诊室的全科医生 (GP) 服务是复杂的干预,其有效性取决于环境.
- 程序理论为修改GP-ED服务以满足当地需求提供了洞察力.
- 在某些情况下,可能需要考虑替代医疗保健服务.
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