精神卫生保健质量改善计划的投资回报;关于概念不确定性和模糊性的德尔菲研究
S'thembile Thusini1, Tayana Soukup2, Claire Henderson3
1Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. s'thembile.thusini@kcl.ac.uk.
精神卫生保健领导人一致认为,质量改进投资回报率 (QI-ROI) 包括货币和非货币利益. 在大多数方面达成共识,尽管在实施结果和福利货币化方面仍然存在一些不确定性.
科学领域:
- 医疗保健管理的管理
- 卫生经济学 卫生经济学
- 提高质量 提高科学 提高质量
背景情况:
- 投资回报率 (ROI) 是评估医疗保健计划,包括质量改进 (QI) 的标准方法.
- 之前的一项研究开发了一个QI-ROI概念框架,确定了精神卫生保健领导者所重视的货币和非货币利益.
- 在QI-ROI概念化中的模糊性需要与更广泛的群体进行进一步的探索.
研究的目的:
- 在多个地点的精神卫生保健领导人之间就质量改进投资回报 (QI-ROI) 概念达成共识.
- 评估共识水平如何影响QI-ROI概念框架的稳定性.
- 探索各种QI福利的感知价值和合法性.
主要方法:
- 两轮Delphi调查在线进行,对英国公共部门的心理健康领导者 (n=23) 进行了调查.
- 参与者评价了67项与患者结果,发展,外部利益,激励,实施结果和货币化利益相关的项目.
- 使用四分位数间范围和中位数来衡量共识,并补充了定性数据.
主要成果:
- 在67%的项目上达成共识;73.3%的共识项目被接受,11.1%被拒绝,15.6%导致不决心.
- 患者的治疗结果和发育效益被评为最相关的QI-ROI组件.
- 外部激励和货币化结果被评为最不相关的;不确定性集中在实施结果和货币化上.
结论:
- 精神卫生保健领导者认为QI-ROI包括货币和非货币利益,受组织需求的影响.
- 虽然大多数方面存在共识,但仍存在一些模两可,特别是在实施结果和福利货币化方面.
- 这些发现对评估QI在类似医疗机构和政策制定中的价值有影响.
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