实施指导方针导向的医疗疗:利益相关者识别的障碍和促进者
Josephine Harrington1, Monica Leyva2, Vishal N Rao1
1Department of Medicine, Division of Cardiology Duke University, Durham, NC; Duke Clinical Research Institute, Durham, NC.
American heart journal
|November 29, 2024
概括
针对心力衰竭的指导指导医学疗法 (GDMT) 面临着实施障碍. 捆绑支付模式为改善GDMT使用提供了比收费服务模式更多的促进者.
科学领域:
- 心脏病学 心脏病学
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 尽管有强有力的证据,心力衰竭与减少喷射率 (HFrEF) 的指南导向医学治疗 (GDMT) 尚未得到充分利用.
- 了解GDMT实施的障碍和促进因素对于改善患者的治疗结果至关重要.
研究的目的:
- 识别各种各样的卫生系统中GDMT实施和定位的障碍和促进者.
- 为了比较服务费和捆绑支付模式之间的实施因素.
主要方法:
- 采访26个卫生系统的利益相关者,使用"实施研究综合框架".
- 在学术,私人,服务费和捆绑支付系统中分析障碍和促进因素.
主要成果:
- 常见的障碍包括缺乏时间,住院到门诊的转变挑战,以及非高频专家之间的知识差距.
- 与收费服务系统相比,捆绑支付系统报告了更多的促进者,如支持人员,机构支持和冠军.
结论:
- 卫生系统在实施GDMT方面遇到类似的障碍.
- 捆绑支付模式似乎为克服这些障碍提供了更多的资源,这表明改善GDMT交付的潜力.
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