需求评估为当地三级教学诊所重新设计服务提供依据

IF 1 Q4 HEALTH POLICY & SERVICES
Christopher Cayco, Andrew M Leaver, Alma Labro, A. Bandong, Anna Christina Domingo, Edward Gorgon
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引用次数: 0

摘要

目的 研究当地一家三级教学诊所的物理治疗在多大程度上实现了最佳实践,并确定服务重新设计的优先领域。方法 对菲律宾马尼拉 2011 年至 2015 年期间接受物理治疗的患者(n = 237)的临床记录进行回顾性档案审查。经过培训的研究人员使用标准化表格提取并编码了临床诊断、干预措施、疗程参数、目标和疗效指标等数据。结果 大多数患者(n = 229,97%)有发育问题。采用了积极的干预措施(人数=236,99%),并在161份(68%)记录中出现了自我管理计划。护理时间长短不一(中位数=16个月,范围=1-139)。几乎所有患者(n = 230,97%)都开始接受每周一次的治疗,治疗总次数从 1 次到 150 次不等(中位数 = 15 次)。治疗目标得到了常规报告(人数 = 236,99%)。209份(88%)记录了基线客观测量结果,136份(57%)记录了随访客观测量结果。结果评估的时间点不一致(范围 = <1-36个月)。结论 诊所提供的服务需要更健全的纵向管理程序、简化的监测机制以及让家庭更好地参与决策。现有实践中的一些要素(积极的自我管理方法)建议采用最佳实践原则。研究结果有助于重新设计服务的 "创意生成"。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Needs Assessment to Inform Service Delivery Redesign in a Local Tertiary Teaching Clinic
Aims To examine the extent to which physical therapy at a local tertiary teaching clinic enables best practice and to identify priority areas for service redesign. Methods A retrospective file review of clinical records of patients receiving physical therapy (n = 237) from 2011 to 2015 in Manila, Philippines. Data on clinical diagnosis, interventions, parameters of episode of care, goals and outcome measures were extracted and coded by trained researchers using a standardised form. Results Most patients (n = 229, 97%) had developmental conditions. Active interventions were employed (n = 236, 99%) and self-management plans appeared in 161 (68%) records. The duration of the episode of care was variable (median = 16 months, range = 1–139). Almost all patients (n = 230, 97%) commenced with weekly sessions, with the total number of sessions ranging from 1 to 150 (median = 15). Therapy goals were reported routinely (n = 236, 99%). Objective measures were recorded in 209 (88%) records at baseline and in 136 (57%) records at follow-up. The time point for outcome assessment was inconsistent (range = <1–36 months). Conclusions Service delivery at the clinic requires more robust longitudinal management procedures, streamlined mechanisms for monitoring and better involvement of the family in decision-making. Some elements of existing practice (active, self-management approaches) suggest the adoption of best practice principles. Results contribute to ‘idea generation’ for service redesign.
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来源期刊
Journal of Health Management
Journal of Health Management HEALTH POLICY & SERVICES-
CiteScore
3.40
自引率
0.00%
发文量
84
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