11个西方国家的通用实践中的案例经理:重复横截面研究
Romane Berret1, Nicolas Senn1, Hubert Maisonneuve2
1Center for Primary Care and Public Health (Unisanté), Department of Family medicine, University of Lausanne, Lausanne, Switzerland.
Swiss medical weekly
|June 17, 2024
概括
在西方国家,在全科医生实践中使用病例经理的数量正在增加,特别是在农村和更大的实践中. 它们的实施与实践特征有关,而不是医生的年龄或性别.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
背景情况:
- 由于人口老龄化和医疗保健需求的增加,初级保健改革至关重要.
- 新的模式正在出现,包括一般实践中的案例经理.
- 病例经理在监测和管理慢性病患者的护理方面发挥着重要作用.
研究的目的:
- 确定从2012年到2019年在11个西方国家的一般实践中案件经理的频率.
- 确定与案例经理频率相关的全科医生和实践特征.
主要方法:
- 联邦基金对初级保健医生的国际卫生政策调查 (2012年,2015年,2019年) 的二次分析.
- 包括来自11个西方国家的全科医生随机样本 (总共超过3.5万名医生).
- 混合效应物流回归分析,以评估实践特征与案例经理使用之间的关联.
主要成果:
- 在2012年至2019年期间,一般实践中的案例经理频率总体上有所增加,国家一级的差异很大.
- 小城镇 (OR 1.4) 和农村地区 (OR 1.9) 的实践报告说,与城市环境相比,案件经理的使用率更高.
- 较大的实践 (较高的全职等效员工四分位数) 显示使用案例经理的数量显著增加 (Q4 OR 3.8).
结论:
- 在一般实践中,案例经理的实施是西方国家的发展和增长趋势.
- 实践地点 (农村/小镇) 和规模与案例经理频率有很大关系.
- 一般医生的个人特征,如年龄和性别,没有被发现是案件经理采用的重要因素.
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