家庭采访改善死亡率审查过程中的卫生服务建议:混合方法评估过程
Catherine Kothari1, Fernando Ospina1, Nia Evans1
1Department of Biomedical Sciences, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA.
概括
在胎儿婴儿死亡率评估 (FIMR) 中的家庭访谈显著增加了健康压力因素的识别和改善建议. 这些采访提供了有价值的见解,推动了医疗保健服务的可操作变化.
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
- 孕产妇和儿童的健康
背景情况:
- 关于在胎儿婴儿死亡率评估 (FIMR) 中对家庭采访对审查小组结果的影响的证据有限.
- 在FIMR和其他审查类型中,扩大家庭采访的动机和潜力很强.
研究的目的:
- 评估FIMR家庭采访对识别卫生服务差距的影响.
- 评估FIMR家庭访谈在产生可行的改进方面的有效性.
主要方法:
- 混合方法设计使用定量案例控制分析和定性半结构面试.
- 对FIMR行政记录 (2015-2023) 的二次分析以及全国范围内对FIMR管理员的定性采访.
- 对定量结果的概括估计方程 (GEE) 分析和对定性经验的专题分析.
主要成果:
- 家庭采访与已识别的压力因素增加了2.6倍,特别是医疗和社会经济方面的压力因素 (aOR=2.6).
- 推的40%增加与家庭访谈有关,特别是在患者与医疗服务提供者的沟通方面 (aOR=1.4).
- 三分之二的FIMR团队发现家庭采访对系统变化"非常有影响力";主要主题包括实施障碍,完成图片和人类联系.
结论:
- 尽管在采访方面存在挑战,但强调了它们在识别根本原因方面的价值.
- 家庭采访产生可行的医疗保健服务建议,并激励系统改进.
- 该研究强调了家庭投入在加强死亡率审查过程中的关键作用.
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