WONCA研究论文摘要汇编--初级医疗团队社会网络对心血管疾病患者医疗质量和费用的效果研究

来源 :中国全科医学 | 被引量 : 0次 | 上传用户:huhaiyan1953
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目的:心血管疾病是美国人口死亡与发病的首要原因。初级医疗团队可以最大化地提高心血管疾病患者的医疗质量,降低医疗成本。本研究探讨初级医疗团队交流、互动、协作(即社会网络)与心血管疾病医疗质量、费用之间的关系。方法从6家初级医疗诊所的31个团队中,选取155名专业医护人员进行社会经济调查,确保调查对象日常进行医疗互动。通过社会网络分析,计算团队互动密度与集中度变量。采用三级模式分析法,评估团队社会网络密度、集中度与过去12个月内控制血压和胆固醇的心血管疾病患者数量、上门急救次数、急诊室来访次数、住院天数、医疗费用之间的关系。结果医疗团队成员的互动密度越大,心血管疾病患者的住院天数就越少〔RR=0.62,95%CI(0.50,0.77)〕,医疗费用就越低〔-$556,95%CI(-$781,-$331)〕。相反,如团队围绕少数个体进行更集中的互动,患者的住院天数就越多〔RR =1.45,95%CI(1.09,1.94)〕,医疗费用就越高〔$506,95%CI ($202,$810)〕。团队内部就目标进行分享与沟通,能够调整社会网络结构与医疗质量之间的关系。结论增强初级医疗团队互动,降低互动集中度,共享团队目标,可以凭借更少的医疗成本获得高质量的心血管医疗服务。
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