提供者提供的电话提醒增加了安全网医院的结肠镜检查完成率
Carlos Fairen Oro1, Sarah Morris1, Samuel Lajoie1
1Department of Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States.
概括
提供者主导的电话提醒等质量改进策略显著提高了安全网医院的结肠镜完成率. 然而,这些干预措施对社会经济不利的患者没有好处,需要采用替代方法.
科学领域:
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结肠镜检查是结肠直肠癌的主要查方法.
- 查结肠镜完成率低于最佳,特别是在为弱势群体服务的安全网医院.
- 低社会经济地位和有限的医疗保健机会有助于降低查率.
研究的目的:
- 实施质量改进战略 (QIS) 以提高结肠镜检查完成率.
- 为了确定与区域贫困指数 (ADI) 分数相关的结肠镜检查完成的趋势.
- 评估医疗服务提供者主导干预与非临床工作人员干预的影响.
主要方法:
- 实施了质量改进战略 (QIS),包括程序前电话提醒和教育.
- 干预措施包括详细的饮食和肠道准备指导,并提供多语言支持.
- 分析了患者数据,包括人口统计数据,无病率,取消和肠道准备质量.
主要成果:
- 在QIS实施后,结肠镜完成率从57.1%增加到81.8% (P <.001).
- 与非临床人员相比,提供者主导的干预措施显示完成率增加了3倍.
- 具有较高社会经济地位的患者 (较低的ADI四分位数) 从QIS中受益,而不是社会经济不利的患者 (较高的ADI四分位数).
结论:
- 电话提醒和教育,特别是来自临床提供者的教育,对于改善医院安全网结肠镜检查的完成至关重要.
- 目前的QIS没有改善高ADI得分的患者的结肠镜完成.
- 需要针对社会经济弱势群体制定有针对性的替代策略,以改善癌症查的准入.
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