一般诊所和二级护理中的护理连续性:回顾性队列研究
Thomas Beaney1, Thomas Woodcock2, Paul Aylin2
1The George Institute for Global Health, Imperial College London, London thomas.beaney@imperial.ac.uk.
概括
在初级和二级环境中,护理的连续性显示出弱关联. 一般实践的连续性并不能改善多种长期疾病 (LTC) 患者的碎片化医院护理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 一般实践 一般实践
背景情况:
- 初级和中等保健的连续性改善了健康结果.
- 持续性的社会人口统计学决定因素在不同环境中可能有所不同.
- 在初级和中级护理中连续性之间的关联不清楚.
研究的目的:
- 在一般实践中检查关系连续性的决定因素.
- 调查多种长期疾病 (LTC) 的患者的分散门诊专科护理.
- 评估通用诊所连续性与门诊专科护理之间的关联.
主要方法:
- 2019年,英格兰18岁以上患者的队列研究.
- 包括212个LTC中≥2个和≥3个全科/门诊预约的患者.
- 计算的护理连续性指数 (COCI) 对于GP和门诊访问;评估的关联.
主要成果:
- 在一般实践中,年龄是连续性最强的决定因素.
- 在二级护理中,LTC数量是最强的决定因素.
- 一般诊所和门诊COCI之间的关联在统计上是显著的,但在临床上是微不足道的.
结论:
- 在全科医院和门诊机构的护理连续性之间存在微弱的关联.
- 在一般实践中增加连续性并不能改善分散的医院护理.
- 需要有针对性的干预措施来加强跨设置的护理协调.
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