在初级保健中为慢性疾病管理提供人口风险分层工具和干预措施:系统文献综述
Davide Golinelli1,2,3, Valentina Pecoraro4,5, Dario Tedesco4,6
1Health Services Research, Evaluation and Policy Unit, Local Health Authority of Romagna, Ravenna, Italy. davide.golinelli@auslromagna.it.
BMC health services research
|April 9, 2025
概括
人口风险分层工具在初级保健中管理慢性病的结果不一. 虽然一些干预措施减少了急诊和死亡率,但对成本和门诊使用的整体影响需要进一步研究.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理医学 医疗保健
- 慢性疾病管理 慢性疾病管理
背景情况:
- 人口风险分层 (RS) 工具在初级保健中用于管理慢性疾病.
- 这些工具旨在为高风险患者量身定制干预措施,并优先分配资源.
研究的目的:
- 在初级保健中探索人口RS工具的证据.
- 评估RS指导干预对慢性病患者和医疗保健利用的影响.
主要方法:
- 关于RCT,CCT和BA的系统文献审查.
- 包括专注于心力衰竭,CKD,糖尿病,COPD或痴呆症的研究.
- 评估结果包括急救诊所,门诊诊所,住院,死亡率和成本.
主要成果:
- 七项研究符合纳入标准.
- 四项研究显示,急诊室 (ED) 访问减少;三项研究显示,住院治疗减少.
- 两项研究表明死亡率降低,但门诊访问和费用显示混合或不确定的结果.
结论:
- 关于RS工具在初级保健中的有效性的证据有限.
- RS工具显示了减少急救诊所访问,住院和死亡率的潜力.
- 需要进一步研究长期效益和成本效益.
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