Litaker David, Tomolo Anne, Liberatore Vincenzo, Stange Kurt C, Aron David
VA HSR&D Center for Quality Improvement Research, Louis Stokes Cleveland Department of Veterans Affairs Medical Center and Department of Medicine, Case Western Reserve University, OH 44106, USA.
J Gen Intern Med. 2006 Feb;21 Suppl 2(Suppl 2):S30-4. doi: 10.1111/j.1525-1497.2006.00360.x.
Previous observational research confirms abundant variation in primary care practice. While variation is sometimes viewed as problematic, its presence may also be highly informative in uncovering ways to enhance health care delivery when it represents unique adaptations to the values and needs of people within the practice and interactions with the local community and health care system. We describe a theoretical perspective for use in developing interventions to improve care that acknowledges the uniqueness of primary care practices and encourages flexibility in the form of intervention implementation, while maintaining fidelity to its essential functions.
以往的观察性研究证实了初级保健实践中存在大量差异。虽然差异有时被视为问题，但当它代表对实践中人们的价值观和需求以及与当地社区和医疗保健系统互动的独特适应时，其存在在揭示改善医疗服务提供的方法方面可能也具有很高的信息量。我们描述了一种理论视角，用于制定改善护理的干预措施，该视角承认初级保健实践的独特性，并鼓励在干预实施形式上保持灵活性，同时对其基本功能保持忠诚。
