实施社区护理医疗服务后的患者流动和安全:一项准实验性研究
Odd Eirik Elden1,2,3, Emma Brulin4, Oddvar Uleberg2,3
1Department of Prehospital Services, Helse Nord-Trondelag HF, Levanger, Norway oddeirik.elden@hnt.no.
BMJ open
|November 5, 2025
概括
社区护理服务 (CPS) 可以通过增加本地治疗和减少住院治疗来改善患者流动. 这项研究发现,CPS不会影响患者的安全,再接触率或死亡率没有变化.
科学领域:
- 公共卫生 公共卫生
- 紧急医疗服务 紧急医疗服务
- 农村医疗保健创新 农村医疗保健创新
背景情况:
- 紧急医疗服务 (EMS) 的压力越来越大,需要创新的解决方案.
- 社区护理医疗服务 (CPS) 具有减轻EMS负担的潜力.
- 关于农村环境中CPS影响的数据有限,特别是在患者流动和安全方面.
研究的目的:
- 评估在挪威的一个农村自治市实施社区护理医疗服务 (CPS) 的效果.
- 为了比较CPS_REGION实施的地区 (CPS_REGION) 和仅由EMS服务的对照地区 (CTR_REGION) 的患者流量和安全结果.
- 为了确定CPS是否会改变住院率和患者处置,而不会影响安全.
主要方法:
- 采用了一个准实验性的,干预前后的研究设计.
- 挪威的两个农村自治市被选中:一个实施CPS (CPS_REGION) 和一个控制 (CTR_REGION).
- 患者流量 (住院,接触者,治疗地点) 和安全性 (再接触7天,30天死亡率) 在CPS引入之前和之后进行了评估.
主要成果:
- 住院率随着时间的推移而增加,在对照区域显著增加 (+23.2%) 但在CPS区域显著减少 (+4.7%).
- 在CPS地区,更多的患者在实施后接受了局部治疗.
- 在任何一个地区都没有观察到7天EMS再接触率或30天死亡率的显著变化.
结论:
- 社区护理医疗服务有效地将患者流向农村环境中的当地治疗.
- 与标准EMS相比,CPS的实施与住院病人的减少增加有关.
- 通过再接触率和死亡率来衡量患者的安全性,在CPS引入后保持不变.
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