"我们正在沉没":一项基于访谈的定性研究,研究了利益相关者对加拿大医疗保健系统结构和流程限制的看法
Jeanna Parsons Leigh1, Stephana Julia Moss2, Sara J Mizen2
1School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada. j.parsonsleigh@dal.ca.
概括
加拿大医疗保健改革至关重要. 利益相关者确定了结构和过程问题,如人员短缺和不一致的护理,倡导角色澄清和以患者为中心的战略,以改善健康结果.
科学领域:
- 医疗保健政策和医疗保健改革
- 医疗服务研究 医疗服务研究
- 人口健康管理 人口健康管理
背景情况:
- 加拿大医疗保健系统改革的努力是渐进式的,导致与其他经合组织国家相比,业绩落后.
- 实质性和有意义的改革对于提高加拿大医疗保健系统的表现至关重要.
- 本研究探讨了加拿大利益相关者对系统性缺陷和改进策略的看法.
研究的目的:
- 了解利益相关者对加拿大医疗保健系统结构和流程缺陷的看法.
- 确定在医疗保健提供和结果方面取得实质性和有意义的改进的策略.
- 探索加拿大身份与医疗保健系统改革之间的联系.
主要方法:
- 与加拿大各地的各种利益相关者进行的半结构化虚拟访谈 (2022年5月至8月).
- 针对四个群体进行有针对性的招聘:公众公民,医疗保健领导人,学者和政治决策者.
- 分析使用了Donabedian的框架 (结构,过程,结果) 和感应性主题分析.
主要成果:
- 确定了三个结构主题:系统反应性,与加拿大身份的联系以及政治/资金结构.
- 揭示了三个过程主题:人员短缺,效率低下的护理和不一致的护理.
- 提出了三个改进策略:角色划分/激励修订,增强健康素养和跨学科/以患者为中心的护理.
结论:
- 加拿大利益相关者强调了国家医疗保健系统内的重大结构和流程限制.
- 有意义的改革需要解决加拿大身份与医疗保健系统之间的联系.
- 需要有效的战略来制定和实施改善措施以提高人口健康结果.
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