背景:系统碎片化是高效组织的主要挑战,整合是医疗保健领域也提出的一种潜在解决方案,包括药房作为一名球员。然而,文献中使用不同的术语和定义阻碍了不同整合举措的比较。
目的:确定和绘制科学文献中关于医疗保健整合的术语,并描述每个新兴主题的特征。
方法:对PubMed索引的医疗保健系统文献的整合进行了词典分析。十种不同的系统搜索,四个仅使用医学主题词(MeSH),六个使用文本单词,于2023年3月进行。使用Leimkuhler模型,根据布拉德福德的分布分析了日志散射。创建了一个整体文本语料库,其中包含检索到的所有记录的标题和摘要。语料库经过了词法处理,最常用的双字母被标记为单串。要执行主题建模,使用IRaMuTeQ分析了词法语料库文本,产生降序分类和对应分析。每个班级中具有较高卡方统计量的50个单词被认为是该班级的代表。
结果:检索了从1943年到2023年在4469种不同期刊上发表的42,479篇文章。医疗服务的基本交付,集成\“,创建于1996年的MeSH更新,检索总文章的33.7%是最有效的,但也检索了22.6%在任何其他搜索中未检索到的文章。文本单词“集成”出现在15,357条(36.2%)记录中。词典分析得出7个类,命名为:证据和实施,定量研究,专业教育,定性研究,治理和领导,临床研究,和财政资源。类别与搜索或使用的文本单词之间的关联范围从中等到弱,表明在有关医疗保健整合的文献中缺乏使用术语的标准模式。
结论:术语“整合”和“医疗服务交付”,“整合”是最常用来代表医疗保健整合的概念,应该是文献中的首选术语。
BACKGROUND: Systems fragmentation is a major challenge for an efficient organization, integration being a potential solution also proposed in health care field, including pharmacy as a player. However, the use of different terms and definitions in the literature hinders the comparison of different integration initiatives.
OBJECTIVE: To identify and map the terms used in scientific literature regarding integration in health care and to characterize each emerging topic.
METHODS: A lexicographic analysis of the integration of healthcare systems literature indexed in PubMed was conducted. Ten different systematic searches, four using only Medical Subject Headings (MeSH) and six using text words, were conducted in March 2023. Journal scattering was analyzed following Bradford\'s distribution using the Leimkuhler model. An overall text corpus was created with titles and abstracts of all the records retrieved. The corpus was lemmatized, and the most used bigrams were tokenized as single strings. To perform a topic modeling, the lemmatized corpus text was analyzed using IRaMuTeQ, producing descending hierarchic classification and a correspondence analysis. The 50 words with higher chi-square statistics in each class were considered as representative of the class.
RESULTS: A total of 42,479 articles published from 1943 to 2023 in 4469 different journals were retrieved. The MeSH \"Delivery of Health Care, Integrated\", created in the 1996 MeSH update, was the most productive retrieving 33.7 % of the total articles but also retrieving 22.6 % of articles not retrieved in any other search. The text word \"Integration\" appeared in 15,357 (36.2 %) records. The lexicographic analysis resulted in 7 classes, named as: Evidence and implementation, Quantitative research, Professional education, Qualitative research, Governance and leadership, Clinical research, and Financial resources. Association between the classes and the searches or the text-words used ranged from moderate to weak demonstrating the lack of a standard pattern of use of terms in literature regarding healthcare integration.
CONCLUSIONS: The term \"integration\" and the MeSH \"Delivery of Health Care, Integrated\" are the most used to represent the concept of integration in healthcare and should be the preferred terms in the literature.