在VA家庭初级保健中定义成功的程序配置:通过调查程序实施中的跨案例异质性来确定关键差异化因素的研究协议
Anaïs Tuepker1,2, Edward J Miech1,3, Elizabeth C Hulen1,4
1Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW U.S. Veterans Hospital Rd, R&D 66, Portland, OR, 97239, USA.
BMC geriatrics
|November 26, 2025
概括
退伍军人事务部的家庭基础初级保健 (HBPC) 计划.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 医疗保健管理的管理
背景情况:
- 退伍军人事务部 (VA) 服务于老龄化的人口.
- 美国退伍军人局的家庭初级保健 (HBPC) 计划为高风险退伍军人提供纵向初级保健.
- 在不同地点实施HBPC有所不同,这为研究异质性提供了机会.
研究的目的:
- 调查HBPC计划实施中的现实世界的异质性.
- 确定影响患者结果的因素,特别是家庭时间.
- 为了告知HBPC计划的未来扩展.
主要方法:
- 探索性的顺序混合方法设计.
- 主要结局:患者在生命的最后180天的家庭时间.
- 二次结果:患者满意度,利用率 (ED访问,住院,长期护理日),护理过渡,宿舍使用,死亡地点.
主要成果:
- 对上下文,运营,文化和护理提供因素的分析.
- 识别区分高与低家庭时间站点的配置.
- 在10个高家庭时间和10个低家庭时间地点进行了定性案例研究.
结论:
- 在项目实施中的现实世界的异质性可以被利用来确定关键的成功因素.
- 了解特定站点的HBPC特征可以指导程序的扩展和改进.
- 区分适应性变异与低效率对于优化老年人护理至关重要.
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