卫生工作者如何体验卫生系统改革:芬兰的一项定性研究
Laura Kihlström1, Marjaana Viita-Aho2, Ilmo Keskimäki3
1Welfare State Research Unit, Finnish Institute for Health and Welfare, Mannerheimintie 166, 00270 Helsinki, Finland; Department of Anthropology, University of South Florida, 4202 E Fowler Ave, Tampa, FL 33620 USA.
芬兰的卫生系统改革使得初级保健工作人员的士气下降,因为他们与他们的经验不一致. 让医疗保健和护理工作人员 (HCWF) 参与是成功实施和保留改革的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
- 公共卫生政策 公共卫生政策
背景情况:
- 医疗系统改革在高收入国家很常见,但它们对医疗保健和护理工作人员 (HCWF) 的影响未得到充分研究.
- 招聘和保留HCWF是全球卫生系统的挑战,通常是改革的目标.
- 了解HCWF的经验对于有效实施改革至关重要.
研究的目的:
- 调查芬兰主要卫生系统改革是如何被初级卫生保健 (PHC) 专业人员体验的.
- 确定影响HCWF参与的因素,并在PHC环境中改革成功.
主要方法:
- 在芬兰的三个PHC中心与48名医生,注册护士和执照实践护士进行了定性采访.
- 利用雪球和有目的的抽样来招募参与者.
- 采用了一种代的定性数据分析过程,其中包含了演和归纳元素.
主要成果:
- 改革的政策目标和PHC工作人员的实际经验之间存在很大的差距.
- 这种失调导致了劳动力丧,影响了对改革合法性的看法.
- 确定了提高HCWF参与度的关键因素,这对于全系统变革至关重要.
结论:
- 调查结果强调了需要更好的领导和实施战略在PHC卫生系统改革.
- 让HCWF参与改革为系统及其员工带来了互惠的好处.
- 如果不参与HCWF,可能会加剧初级保健领域现有的劳动力短缺问题.
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