联邦对初级保健转型的投资:系统审查和定性分析
Laura L Sessums1, Timothy J Day2, Lingrui Liu3
1American Board of Internal Medicine, Philadelphia, Pennsylvania.
JAMA health forum
|November 7, 2025
概括
联邦对初级保健转型的投资改善了实践经验和人口健康. 然而,患者体验和成本结果是混合的,数据访问和支付系统的挑战限制了影响.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理政策 基本护理政策
- 医疗保健管理的管理
背景情况:
- 了解联邦对初级保健的投资影响对于改善护理提供至关重要.
- 关键的利益相关者包括从业人员,程序开发人员和政策制定者.
- 初级保健转型旨在提高患者的治疗结果和系统效率.
研究的目的:
- 评估联邦对初级保健服务转型投资的结果.
- 评估对患者体验,成本,利用,人口健康和实践经验的影响.
- 了解未来的初级保健改进策略.
主要方法:
- 对公开可用的项目评估报告和文章进行系统审查.
- 在多个数据库 (PubMed,Scopus等) 进行了搜索. 对于从2011年7月到2024年12月的研究.
- 包括2011年1月之后启动并于2021年12月完成的独立评估的联邦计划.
主要成果:
- 分析了来自5个联邦计划 (FQHC APC,MPAPC,CPC,CPC Plus,EvidenceNOW) 的142个记录.
- 投资支持通过支付,绩效,数据和技术援助来改变实践.
- 与改善的临床护理,患者参与,适度的利用减少,但增加的支出有关.
结论:
- 初级保健投资改善了实践经验和人口健康;患者经验和成本结果是混合的.
- 障碍包括数据访问,支付系统挑战和长时间实施 (≥2年).
- 未来的努力需要解决实践障碍,调整支付,并支持当地组织改进.
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