在初级保健中确定患者小组规模:一个元叙事审查
Abd Moain Abu Dabrh1, Wigdan H Farah2, Heidi M McLeod1
1Mayo Clinic, Jacksonville, FL, USA.
Journal of primary care & community health
|February 20, 2025
概括
在初级保健中确定理想的患者小组大小 (PPS) 是复杂的. 较小的小组与更好的患者满意度和护理连续性相关,但临床结果显示影响最小.
科学领域:
- 初级医疗保健医学 一级医疗保健医学
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
背景情况:
- 在初级保健机构中,最佳的患者小组大小 (PPS) 定义不清楚.
- 影响PPS的因素及其对患者结果的影响需要进一步调查.
研究的目的:
- 进行一项元叙述性审查,评估影响患者小组规模 (PPS) 的因素.
- 评估PPS与各种患者结局之间的关联,包括临床,过程和利用措施.
主要方法:
- 进行了全面的元叙事文献综述.
- 从创立到2023年12月的电子数据库中搜索原始研究.
- 包括48项报告PPS决定因素和相关结果的研究.
主要成果:
- 确定了影响PPS的7个关键因素,包括患者的人口统计 (年龄,性别,并发症) 和实践特征 (类型,结构).
- 较小的小组与改善患者满意度,护理连续性和健康促进有关.
- 临床结果,资源利用和成本与PPS的相关性很小.
- 女临床医生和社区中心经常管理较小的小组,为不同的患者群体提供服务.
结论:
- 理想的PPS是多因素的,受实践环境,患者人口统计和临床医生的属性影响.
- 患者报告的结果与PPS比与实践相关的因素更强烈地相关.
- 初级保健实践应根据患者群体定制小组大小,并确保可靠的基础设施,以提供最佳的以患者为中心的护理.
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