改善获取,混合连续性:多学科团队对芬兰初级医疗保健的影响 - - 一项准实验性研究
Elisa Jokelin1, Laura Piirainen2, Erja Mustonen3
1Department of Public Health, University of Helsinki.
Scandinavian journal of primary health care
|May 8, 2025
概括
在初级保健中,一个新的多学科团队 (MDT) 模型显著改善了患者的接入,减少了等待时间. 虽然护理连续性显示出混合的结果,但MDT方法为改善初级保健提供提供了一个有希望的策略.
科学领域:
- 初级保健创新初级保健的创新
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高科学 提高质量
背景情况:
- 多学科团队 (MDT) 方法是初级保健中的新兴模式,对其对四重目标 (QA) 目标的影响数据有限.
- 评估新型MDT的实施对于了解它们在改善医疗保健提供方面的有效性至关重要.
研究的目的:
- 评估一种新的护士-医生MDT模型对初级保健机构的护理接入和连续性的影响.
- 将新MDT模型的有效性与已建立的初级保健模型进行比较.
主要方法:
- 一项准实验性研究,比较了五个干预中心和三个控制中心.
- 包括所有从2021年到2023年的初级保健患者,以及干预前后收集的数据.
- 实施护士-医生模式,护士的病例管理,以及精益日常管理原则.
主要成果:
- 在干预中心,获得护理的机会显著改善,第三次可用预约 (T3) 度量从90天下降到1.125-4.75天.
- 三个干预中心的护理连续性 (COC) 改善,但在两个中心下降;控制中心也显示COC的下降.
- 仅供医生使用的T3和COC指标用于评估.
结论:
- 与传统模式相比,新型MDT模型有效地提高了对初级保健的准入.
- 仅仅"第三次可用的约会" (T3) 指标可能无法完全捕捉干预措施的有效性.
- 在护理连续性的混合结果需要进一步的研究来优化MDT策略.
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