在英格兰的综合护理系统中,不同看待酒精的障碍和杆点:高级利益相关者采访研究研究
Mary Madden1, Duncan Stewart2, Jim McCambridge1
1University of York, York, UK.
BMJ public health
|February 28, 2025
概括
综合护理系统 (ICS) 需要一个国家减少酒精危害的战略. 在ICS中解决酒精问题可以改善人口健康,但需要更好的整合和初级保健重点.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 成 药物 药物 药物 药物
背景情况:
- 综合护理系统 (ICS) 是英格兰针对本地医疗和社会护理整合的最新举措.
- 酒精危害在国家卫生服务 (NHS) 中受到有限的国家战略关注,尽管负担在当地有很大的差异.
- 现有的压力和ICS内部不清楚的问责制给有效的服务提供带来了挑战.
研究的目的:
- 在两个对比的ICS中检查有关酒精危害的决策过程和进展.
- 识别系统性障碍和潜在的杆点,以解决酒精危害,特别是在初级保健.
- 探索酒精战略优先考虑对ICS新视角和行动的影响.
主要方法:
- 在两个北英格兰ICS中进行定性案例研究设计,酒精优先级不同.
- 与14位高级利益相关者进行了深入的半结构化访谈.
- 采访数据的建构主义主题分析.
主要成果:
- ICS的形成恰逢服务压力和不清楚的沟通和问责制线路.
- 发现了酒精损害的预防和治疗服务之间的基本断裂.
- 在ICS中对酒精的战略优先考虑导致了新的观点和行动,尽管容量仍然是一个问题. 将酒精重新定义为临床药物显示了预防并发症和提高NHS有效性的潜力.
结论:
- 在ICS中,必须采取一个整体的,全系统的方法来解决酒精危害问题.
- 强烈建议制定国家NHS酒精战略,以指导ICS决策,并将NHS的工作与公共卫生联系起来.
- 解决酒精问题需要更好的整合,更明确的问责制,以及在不断发展的医疗保健系统中的战略重点.
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