在跨专业团队护理时代衡量初级保健生产力:利益相关者,范围审查和实施视角
Lisa V Rubenstein1,2,3, Sydne J Newberry2, Ishita Ghai3
1Geffen School of Medicine and Fielding School of Public Health, University of California, Los Angeles.
目前的初级保健生产率指标未能捕捉到跨专业团队的价值. 新的经济模型可以更好地衡量初级保健效率和结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 初级医疗保健医学 一级医疗保健医学
- 卫生经济学 卫生经济学
背景情况:
- 目前的初级保健生产率指标不足,因为它们不考虑对跨专业团队的投资,也不符合人口健康目标.
- 这项研究探讨了测量初级保健生产力和效率的替代方法.
研究的目的:
- 评估应用经济方法来衡量初级保健生产力的可行性.
- 开发新的指标,准确地反映初级保健结构,目标和价值观,包括跨专业团队投资和高价值产出.
主要方法:
- 2008-2023年文献的范围审查确定了关于初级保健生产率和效率的研究.
- 一个经过修改的Delphi专家小组完善了潜在的用例,分析方法和数据元素,用于新的生产力指标.
主要成果:
- 大多数研究 (76%) 使用经济模型,主要是数据包裹分析 (DEA),其中初级保健人员是最常见的输入.
- 结果包括护理质量 (53%) 和临床活动 (53%),但不包括患者报告的经验.
- 专家小组成员建议专注于效率,使用例行收集的数据,计算全职同等人员,并纳入护理质量.
结论:
- 已经确定了与经济和初级保健原则相一致的测量方法,但尚未常规实施.
- 有机会开发能够准确反映初级保健复杂结构,人口健康目标和核心价值观的指标.
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