背景:患有多种长期疾病的患者需要了解现有的护理模式,以解决其复杂和多方面的健康需求。然而,目前的文献缺乏对基本组成部分的全面概述,影响,挑战,以及这些护理模式的促进者,提示此范围审查。
方法:根据系统评价的首选报告项目和范围审查的Meta分析扩展指南进行范围审查。我们的搜索包含PubMed的文章,WebofScience,EMBASE,Scopus,谷歌学者。世界卫生组织的卫生系统框架被用来综合研究结果。该框架包括六个组成部分(服务交付,卫生劳动力,卫生信息系统,获得基本药物,融资,和领导力/治理)和良好服务交付模式的八个关键特征(访问、覆盖范围,质量,安全,改善健康,响应性、响应性社会和金融风险保护,并提高效率)。定性合成结果以识别成分,影响,障碍,和护理模式的推动者。
结果:护理模式代表了旨在实现预期结果的医疗服务中的各种集体干预措施。这些护理模式的名称来自核心活动或主要职责,参与医疗团队,疾病状况,符合条件的客户,目的,和护理设置。著名的护理模式包括综合,协作,集成-协作,引导,护士领导的,老年病学,和慢性护理模式,以及全包养老模式,IMPACT诊所,和老年患者对齐护理团队(GeriPACT)。其他护理模式(包括CareManagementPlus,值流映射,预防性家访,过渡关怀,自我管理,和护理协调)补充了主要的。护理模式提高了护理质量(例如,以病人为中心,及时性、及时性安全,效率),护理费用,以及患者的生活质量,系统和功能集成,资源的可用性,支持工具。
结论:实施护理模式是为了提高护理质量,健康结果,成本效率,通过考虑仔细招募合格客户,以及患者满意度,适当选择服务交付设置,以及涉及领导角色的强有力的组织安排,医疗团队,财政支持,和卫生信息系统。不同的团队组成及其在服务提供过程中的角色区分了护理模式。
BACKGROUND: Patients with multiple long-term conditions requires understanding the existing care models to address their complex and multifaceted health needs. However, current literature lacks a comprehensive overview of the essential components, impacts, challenges, and facilitators of these care models, prompting this scoping review.
METHODS: A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Extension for Scoping Reviews guideline. Our search encompassed articles from PubMed, Web of Science, EMBASE, SCOPUS, and Google Scholar. The World Health Organization\'s health system framework was utilized to synthesis the findings. This framework comprises six building blocks (service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance) and eight key characteristics of good service delivery models (access, coverage, quality, safety, improved health, responsiveness, social and financial risk protection, and improved efficiency). Findings were synthesized qualitatively to identify components, impacts, barriers, and facilitators of care models.
RESULTS: A care model represents various collective interventions in the healthcare delivery aimed at achieving desired outcomes. The names of these care models are derived from core activities or major responsibilities, involved healthcare teams, diseases conditions, eligible clients, purposes, and care settings. Notable care models include the Integrated, Collaborative, Integrated-Collaborative, Guided, Nurse-led, Geriatric, and Chronic care models, as well as All-inclusive Care Model for the Elderly, IMPACT clinic, and Geriatric Patient-Aligned Care Teams (GeriPACT). Other care models (include Care Management Plus, Value Stream Mapping, Preventive Home Visits, Transition Care, Self-Management, and Care Coordination) have supplemented the main ones. Care models improved quality of care (such as access, patient-centeredness, timeliness, safety, efficiency), cost of care, and quality of life for patients that were facilitated by presence of shared mission, system and function integration, availability of resources, and supportive tools.
CONCLUSIONS: Care models were implemented for the purpose of enhancing quality of care, health outcomes, cost efficiency, and patient satisfaction by considering careful recruitment of eligible clients, appropriate selection of service delivery settings, and robust organizational arrangements involving leadership roles, healthcare teams, financial support, and health information systems. The distinct team compositions and their roles in service provision processes differentiate care models.