为患有医疗复杂性的儿童提供综合护理计划
Adrienne R Harvey1, Elaine Meehan1, Nicole Merrick2
1Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia.
The Cochrane database of systematic reviews
|May 30, 2024
概括
对患有医疗复杂性 (CMC) 的儿童的综合护理计划对儿童或父母的健康结果几乎没有显著影响. 有证据表明,这些计划可能会稍微提高满意度,但不会显著改变医疗保健利用率或成本.
科学领域:
- 儿科医疗保健 儿科医疗保健
- 复杂的护理管理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 患有医疗复杂性 (CMC) 的儿童有很高的医疗保健需求和功能限制.
- 专门的综合护理计划旨在改善CMC的结果并降低成本.
- 这些计划的有效性仍然不清楚.
研究的目的:
- 评估CMC综合护理计划的有效性.
- 评估对儿童和父母健康,生活质量,医疗保健利用率和成本的影响.
- 为了确定是否有效性因程序设置和结构而异.
主要方法:
- 随机和非随机试验,受控前后研究和中断时间序列的系统审查.
- 搜索了CENTRAL,MEDLINE,Embase,CINAHL,参考目录,审判登记册和灰色文献. 没有找到.
- 包括比较综合护理计划与CMC常规护理的研究.
主要成果:
- 包括4项涉及912个CMC的随机对照试验.
- 综合护理在儿童/父母健康,功能或生活质量方面几乎没有差异.
- 观察到儿童/家庭满意度略有改善;医疗保健利用率和成本没有显著变化.
- 在所有结果中,证据确定性从低到中等不等.
结论:
- 目前关于CMC综合护理有效性的证据有限,确定性低至中等.
- 需要更多高质量,一致的研究,包括成本分析.
- 由于现有研究的质量有限和可变,无法得出明确的结论.
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