在安大略省常见的外科手术的转诊模式:一个横截面人口水平的研究
Pardis Seyedi1, Dionne Aleman1, Nancy Baxter1
1From the Department of Mechanical & Industrial Engineering, University of Toronto, Toronto, Ont. (Seyedi, Aleman, Bodur, Carter); Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia (Baxter); the Department of Medicine, Sinai Health System, Toronto, Ont. (Bell); the Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ont. (Bell); ICES (Calzavara, Emerson), Research and Analysis (Lee); the Department of Ophthalmology, Queen's University, Kingston, Ont. (Campbell); the Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, N.S. (de Jager); the University Health Network, Toronto General Research Institute, Toronto, Ont. (Gagliardi); the University Health Network, Otolaryngology, Head and Neck Surgery, Toronto, Ont. (Irish); the Department of Family and Community Medicine, University of Toronto, Toronto, Ont. (Martin); the Medfall Group, St. Catharines, Ont. (Saxe-Braithwaite); the Women's College Hospital, Toronto, Ont. (Takata); Data and Decision Sciences, Ontario Health (Yang); Ontario Health (Cancer Care Ontario), Access to Care, Toronto, Ont. (Zanchetta); the Department of Surgery, Women's College Hospital, Toronto, Ont. (Urbach).
大多数医生将患者推给少数外科医生,这表明缺乏个性化的外科推. 了解这些转诊网络是改善手术等待时间和护理协调的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 手术护理 提供手术护理
- 网络分析 网络分析
背景情况:
- 加拿大的专业外科护理依赖于在一个不受管理的市场中直接的医生转诊.
- 人们对这些推网络的结构和功能知之甚少.
- 现有的转诊模式可能会成为实施协调护理模式的障碍.
研究的目的:
- 描述和分析医生和外科医生之间在安大略省的常见外科手术中推网络.
- 确定手术护理单入模式的潜在障碍.
主要方法:
- 利用安大略省行政数据,分析了2016-2019年9项常见外科手术的转诊网络.
- 描述性测量和社交网络分析,以评估推医生和外科医生的联系.
主要成果:
- 推网络结构因手术程序而异.
- 脊柱手术网络高度集群;胆囊,和子宫手术网络分布.
- 乳腺癌手术网络分布,但偏差,少数组管理更多的患者.
结论:
- 协调外科推需要解决现有推网络的固有结构.
- 医生通常会向有限数量的外科医生推,这表明推的个性化程度有限,基于患者的具体情况.


