一个新的短期人员和远程医疗计划的纵向评估:一个回顾性观察性研究
Paige Carlson1, Bjarni Haraldsson2, Matthew R Augustine3,4
1Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, USA.
Journal of primary care & community health
|February 28, 2026
概括
在VHA中的临床资源中心 (CRH) 可以增加患者的等待时间. 虽然CRH提供远程人员解决方案,但需要进一步改进,以提高获得初级保健的机会.
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
- 远程医疗远程医疗
背景情况:
- 获得初级保健至关重要,但由于退伍军人卫生管理局 (VHA) 内的供应商短缺而受到挑战.
- 临床资源中心 (CRH) 在VHA中实施,以提供远程临床医生并解决短期的人员短缺问题.
研究的目的:
- 评估临床资源中心 (CRH) 使用对VHA内的初级保健准入的影响.
- 评估CRH使用与关键访问指标之间的关联,包括患者等待时间和及时护理.
主要方法:
- 从2020年10月到2024年9月对VHA初级保健诊所进行纵向分析.
- 定义的CRH用户诊所是那些连续两个月每月至少有10次CRH访问的诊所.
- 使用具有强大的标准误差的通用线性混合模型来分析CRH使用和访问结果之间的关联.
主要成果:
- 37.1%的VHA初级保健诊所使用CRH服务.
- 使用CRH与既定 (0.35天) 和新患者等待时间 (0.69天) 的显著增加有关.
- 使用CRH的诊所的及时护理减少了1.40%.
结论:
- 与临床资源中心的接触与患者等待时间略长相关.
- 虽然CRH为远程人员提供解决方案,但需要额外的策略来完全弥合初级保健准入差距.
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