个人GP连续性改善了初级保健群体的医疗保健结果 - - 一项系统性审查
Sven Göran Engström1, Malin André2, Eva Arvidsson2
1Futurum Academy of Health and Care, Sydney, Australia sven.g.engstrom@telia.com.
概括
与全科医生建立强大的个人连续性,可能会减少初级保健群体的过早死亡,住院和急诊室访问. 这些发现凸显了患者与医生关系的一致性对医疗保健结果的重大影响.
科学领域:
- 初级保健研究研究初级保健研究
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 与全科医生 (GP) 进行个人护理的连续性被认为是初级保健的关键特征.
- 然而,支持其在一般初级保健人群中的益处的强有力的证据仍然有限.
研究的目的:
- 系统地调查与全科医生的个人护理连续性和初级保健机构内的医疗保健结果之间的关联.
- 综合现有的定量证据,分析患者与GP关系连续性对死亡率和医疗保健利用率的影响.
主要方法:
- 进行了定量研究的系统审查,从2000年1月到2023年10月搜索Embase,PubMed,Scopus和Web of Science.
- 由于异质性,对包括的18项研究 (来自5,792个参考) 进行了叙事综合,使用GRADE框架评估结果的确定性.
主要成果:
- 与全科医生更高的个人连续性与可能减少过早死亡率有关 (中等确定性,4项研究,560万参与者).
- 中等确定性证据表明,更高的连续性可能会减少住院 (11项研究,136万参与者) 和急诊室 (7项研究,390万参与者).
结论:
- 在初级保健中,医生与患者关系的个人连续性增加与更好的健康结果有关,包括较低的死亡率和减少的医疗保健利用率.
- 即使在个人连续性的适度改进也可以显著减少医疗保健消费,影响医疗保健的获取和医疗保健政策的信息.
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