以患者为中心优先考虑多重疾病的医疗保健过程
Linnaea Schuttner1,2, Mariah Theis1, Edwin Wong1,3
1Health Services Research & Development, VA Puget Sound Health Care System, Seattle, Washington.
JAMA network open
|December 15, 2025
概括
对患有多种慢性疾病 (多种疾病) 的患者优先考虑医疗保健过程应与以患者为中心的目标保持一致. 烟草使用查成为死亡率,症状缓解和功能目标的首要任务.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床决策 临床决策
- 以患者为中心的护理
背景情况:
- 初级保健包括各种服务,包括预防性查和慢性疾病管理.
- 临床医生经常根据时间限制或感知到的疾病影响来优先考虑医疗保健过程,特别是在多病症患者中.
- 根据以患者为中心的健康目标优先考虑医疗保健过程的证据有限.
研究的目的:
- 确定在多病症护理中优先考虑医疗保健过程的标准.
- 为医疗保健过程制定推的优先级排名,与以患者为中心的健康目标保持一致.
主要方法:
- 通过21名国家专家的多标准决策分析,制定了一份共识声明.
- 两个电子调查轮进行了权重标准和评分53个医疗保健过程与患者目标 (死亡率,症状缓解,身体功能) 相比.
- 使用蒙特卡洛模拟来评估对衍生排名的信心.
主要成果:
- 选择了七个标准:可操作性,安全影响,易于完成,对高流行问题的影响,证据质量,长期结果影响和有效性.
- 烟草使用查被列为所有患者目标的最高优先级医疗保健过程.
- 其他医疗保健过程的排名因患者的具体目标而异.
结论:
- 基于以患者为中心的目标优先考虑医疗保健过程,产生了各种标准和排名.
- 这些发现可以为卫生系统选择优质举措提供信息,并帮助临床医生为多病症患者提供个性化的护理.
- 这种方法在临床实践中促进了以目标为导向的对话和有效的流程管理.
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