一项试验性研究,利用澳大利亚常规收集的数据,考察了改善非原住民酒精和其他药物治疗服务文化响应性的实用流程的影响。

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES
Alexandra Henderson, Anthony Shakeshaft, Julaine Allan, Raechel Wallace, Daniel Barker, Sara Farnbach
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引用次数: 0

摘要

目的:常规健康数据有可能近乎实时地发现患者相关结果的变化。本试点项目使用常规数据来探索和比较文化响应性的变化对澳大利亚土著居民和托雷斯海峡岛民(以下简称土著居民)客户使用服务的影响:从 2019 年 3 月至 2021 年 9 月(干预前四个月至干预后两年;数据分析时间为 2022 年 3 月至 2023 年 2 月)的 30 个月期间,为 11 家服务机构提供了新南威尔士州酒精和其他药物使用治疗服务最低数据集 (MDS)。通过对基线和两年内的服务进行实践审计,评估文化响应能力的变化。采用线性混合回归模型对审计评级的平均变化进行分析。使用广义线性混合模型来确定原住民客户在使用服务方面的变化。结果显示所有 11 项服务的审核评分在两年后均有所提高,平均提高 18.6 分(满分 63 分;b = 18.32,95% CI 12.42-24.22),具有显著的统计学意义。在以下方面没有发现有统计学意义的前后变化:(1)为原住民与非原住民客户提供的护理次数比例(OR = 1.15,95% CI = 0.94-1.40),(2)每月为原住民客户提供的护理次数(IRR = 1.01,95% CI = 0.84-1.23),或(3)原住民客户完成的护理次数比例(OR = 0.96,95% CI = 0.82-1.13)。结论:使用 MDS 对服务使用结果缺乏统计学意义上的显著影响,这与文化响应能力的提高形成了鲜明对比,表明还需要进一步的工作来确定适当的结果测量方法。这可能包括患者报告的体验测量。该项目表明,常规数据有可能成为一种有效的方法,用于衡量医疗服务改善后患者相关结果的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A pilot study examining the impact of a pragmatic process for improving the cultural responsiveness of non-Aboriginal alcohol and other drug treatment services using routinely collected data in Australia.

Objective: Routine health data has the potential to identify changes in patient-related outcomes, in close to real time. This pilot project used routine data to explore and compare the impact of changes to cultural responsiveness on service use by Aboriginal and Torres Strait Islander (hereafter, Aboriginal) clients in Australia.Methods: The New South Wales Minimum Data Set (MDS) for alcohol and other drug use treatment services was provided for 11 services for a period of 30 months from March 2019 to September 2021 (four months prior to two years after the intervention; data were analysed between March 2022 to February 2023). Change in cultural responsiveness was assessed via practice audits of services at baseline and two years. The average change in audit rating was analysed using a linear mixed regression model. Generalised Linear Mixed Models were used to identify changes in service use by Aboriginal clients. Results: All 11 services showed increased audit scores at two years, with a statistically significant mean increase of 18.6 (out of 63 points; b = 18.32, 95% CI 12.42-24.22). No statistically significant pre-to post-changes were identified in: (1) the proportion of episodes delivered to Aboriginal versus non-Aboriginal clients (OR = 1.15, 95% CI = 0.94-1.40), (2) the number of episodes of care provided to Aboriginal clients per month (IRR = 1.01, 95% CI = 0.84-1.23), or (3) the proportion of episodes completed by Aboriginal clients (OR = 0.96, 95% CI = 0.82-1.13). Conclusions: The lack of statistically significant impact on service use outcomes using MDS contrasts to the improvements in cultural responsiveness, suggesting further work is needed to identify appropriate outcome measures. This may include patient-reported experience measures. This project showed that routine data has potential as an efficient method for measuring changes in patient-related outcomes in response to health services improvements.

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来源期刊
CiteScore
4.40
自引率
4.20%
发文量
39
期刊介绍: Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.
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