增强综合护理计划:一项由全科医生领导的多学科团队对患者组合的回顾性研究,以减少急性护理利用率
Norshima Nashi1, Derek Kam Weng Chan1, Ginny Jing Xian Goh1
1Department of Medicine, National University Hospital, Singapore.
增强综合护理计划 (ECCP) 显著减少了新加坡老年人复杂需求的住院和急诊室访问. 这种以患者为中心的护理模式显示出改善医疗保健效率的前景.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 新加坡人口老龄化给医疗保健系统带来了挑战,原因是复杂的多病症和心理社会问题.
- 护理协调和连续性的差距会导致不良健康结果,急性护理使用增加,医疗保健成本增加.
- 建议采用一种从芝加哥大学综合护理医生模型中改编的患者组合方法.
研究的目的:
- 评估加强综合护理计划 (ECCP) 在减少急性护理利用方面的有效性.
- 评估ECCP对住院和急诊室 (ED) 访问的影响.
主要方法:
- 在新加坡国立大学医院进行的回顾性,准实验性,匹配控制的观察性研究.
- 主要结果:在ECCP注册前和之后的6个月内住院和ED访问.
- 倾向性得分匹配用于在干预和对照组之间平衡医疗保健利用率.
主要成果:
- 在2019年10月至2020年4月期间,有57名参与者注册.
- 干预后平均住院 (1.90至0.58,P<0.001) 和急救室访问 (1.96至0.77,P<0.001) 的显著减少.
- 倾向匹配分析显示,与对照组相比,ECCP干预组的住院病例减少了 (P < 0.001对P = 0.04).
结论:
- 增强综合护理计划 (ECCP) 证明了减少急性护理利用率的潜在好处.
- 通过ECCP重新设计医疗保健可能会改善脆弱,老龄化人口的复杂健康需求的结果.
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