重组儿科康复服务以提高可及性：我们是否牺牲了质量？
Reorganizing pediatric rehabilitation services to improve accessibility: do we sacrifice quality?
机构信息
Estrie Rehabilitation Center, Sherbrooke, Québec, Canada.
出版信息
BMC Health Serv Res. 2010 Aug 5;10:227. doi: 10.1186/1472-6963-10-227.
BACKGROUND
The impact of a pediatric rehabilitation service delivery reorganization to improve access to services on parents' and service providers' perception of service quality was evaluated. Child-, family-, service- and service provider-related characteristics possibly associated with these perceptions were explored.
METHODS
Perceptions were measured using the Measure of Processes of Care tools and open ended questions before (2007), during (2008) and following (2009) service reorganization. Child and family characteristics, services received and service provider data were documented. Mean MPOC scores were compared over time (ANOVAs and Generalized Estimating Equations) and t-tests, correlations and ANOVAs determined whether the characteristics influenced scores.
RESULTS
Families' (n = 222) and service providers' (n = 129) perceptions of quality were high in 2007 (3.67 to 6.31/7) and remained high over the next 2 years (p >or= 0.16). Two MPOC domain scores (Respectful care and Providing general information) were consistently scored the highest (mean >or= 5.66/7) and the lowest (mean <or= 4.75/7), respectively. Families with more education and those with children 12-21 years old tended to attribute lower MPOC scores. Participants were generally satisfied with the new service model and recommendations included improving information exchange.
CONCLUSIONS
Results suggest that it is possible to reorganize pediatric rehabilitation services while maintaining quality.
背景
评估了改善服务获取途径的儿科康复服务提供重组对家长和服务提供者对服务质量感知的影响。探讨了可能与这些感知相关的儿童、家庭、服务和服务提供者特征。
方法
在服务重组之前（2007 年）、期间（2008 年）和之后（2009 年）使用护理过程测量工具和开放式问题测量感知。记录儿童和家庭特征、接受的服务和服务提供者数据。使用方差分析和广义估计方程以及 t 检验比较随时间的平均 MPOC 评分，相关性和方差分析确定特征是否影响评分。
结果
家庭（n=222）和服务提供者（n=129）在 2007 年的质量感知较高（3.67 至 6.31/7），并在接下来的 2 年中保持较高水平（p≥0.16）。两个 MPOC 域评分（尊重护理和提供一般信息）得分始终最高（平均值≥5.66/7）和最低（平均值<4.75/7）。受教育程度较高的家庭和 12-21 岁的儿童的家庭往往归因于较低的 MPOC 评分。参与者普遍对新的服务模式感到满意，并提出了改进信息交流的建议。
结论
结果表明，在维持服务质量的同时，有可能对儿科康复服务进行重组。
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