在初级保健中咨询护理医生或全科医生:前性研究比较成本和结果
William Hollingworth1, Nouf S Gadah-Jeynes1, Hazel Taylor2
1Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol.
概括
在全科医生 (PGP) 咨询中,护理人员的咨询并没有显著改变患者的健康结果. 虽然PGPs可以减少GP的工作量,但由于增加了其他医疗保健专业人员的使用,他们没有降低NHS总体成本.
科学领域:
- 医疗保健管理的管理
- 初级保健研究研究初级保健研究
- 护理人员实践 护理人员实践
背景情况:
- 英格兰的全科医生面临着来自患者需求增加和全科医生短缺的巨大压力.
- 全科医生 (PGPs) 的护理人员越来越多地被整合到管理轻微疾病,进行家庭访问,并提供紧急咨询,增加全科医生能力.
研究的目的:
- 调查护理人员在全科医院 (PGPs) 提供的咨询对患者报告经验的影响.
- 评估PGP咨询对患者病情安全管理的影响.
- 评估PGP咨询对国家卫生服务 (NHS) 成本的影响.
主要方法:
- 在英格兰的34个GP地点进行了前性队列研究.
- 参与者在2022年5月至2023年2月期间被招募,咨询涉及PGP (25个地点) 或GP (9个地点).
- 患者报告的结果,包括经验,感知安全,生活质量和医疗保健利用情况,通过咨询后立即通过问卷和30天的随访评估.
主要成果:
- 在30天的PGP和GP咨询之间,没有观察到患者报告的健康和福祉,对健康服务的信心,健康知识或对健康计划的信心的显著差异.
- 在咨询后立即,患者报告对医疗保健的信心较低,对安全促进参与的看法较差,与GP组相比,PGP组的员工有更多的沟通问题.
- 虽然PGP咨询导致了更少的GP预约,但潜在的NHS储蓄被其他医疗保健专业人员的使用增加所抵消.
结论:
- 有效的培训和监督至关重要,为PGPs提供必要的知识和沟通技巧,以便向患者传达医疗保健计划.
- 虽然PGPs可能可以减轻GP工作负载的压力,但其实施本身不会导致整体NHS成本的降低.
- 需要进一步的研究和优化实施策略,以最大限度地利用PGPs在初级保健机构中的好处.
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