为患有多种慢性病或有多种慢性病风险的人提供以人为本的护理规划
Brittany N Watson1, Lilly Estenson2, Aimee R Eden3
1Department of Family and Community Medicine, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina.
JAMA network open
|October 17, 2024
概括
以人为中心的护理规划 (PCCP) 解决了多重慢性疾病 (MCC) 患者的需求. 确定了实施PCCP的策略和障碍,以提高护理质量和价值.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 以患者为中心的护理
- 慢性疾病管理 慢性疾病管理
背景情况:
- 美国面临着越来越多患有多重慢性疾病 (MCC) 的人口,但医疗保健系统仍在努力满足他们的复杂需求.
- 以人为中心的护理计划 (PCCP) 是量身定制综合护理的重要方法,旨在改善健康结果和医疗保健价值.
- 现有的系统往往缺乏设计和集成,以有效地为患有MCC的个人提供PCCP.
研究的目的:
- 确定为患有或有MCC风险的个人提供PCCP的策略.
- 探索与实施PCCP相关的促进者和障碍.
- 为未来的研究和实施工作提供信息,以便广泛采用PCCP.
主要方法:
- 一项定性研究,采用对卫生保健研究和质量机构 (AHRQ) 对信息请求 (RFI) 的回应进行主题分析.
- 在2022年底公开公开评论的RFI中,征求各方利益相关方对PCCP的意见.
- 分析涉及58名受访者,包括患者,护理人员,临床医生和组织代表的开放文本响应的诱导和演编码.
主要成果:
- 九个关键主题出现了:低于最佳的护理质量,以人为中心和目标一致的护理的重要性,多学科的团队为基础的护理和协调,以及终身预防.
- 其他主题包括数字健康解决方案,工作流集成,教育和自我管理支持,支付模式,以及社区,卫生系统和付款人目标的协调.
- 对PCCP采用所面临的挑战包括支付调整,政策支持,文化变化以及需要有意义的质量措施.
结论:
- 广泛采用PCCP面临的挑战需要战略解决方案,包括支付改革,政策调整和医疗保健系统内的文化转变.
- 开发和传播基于证据的扩大和传播PCCP的策略对于其成功融入常规护理至关重要.
- 这些发现为优先考虑研究和指导实施倡议提供了宝贵的见解,以推进MCC患者的PCCP.
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