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国家卫生与医院改革委员会最终报告及以患者为中心的改革建议。

National Health and Hospital Reform Commission final report and patient-centred suggestions for reform.

作者信息

Jowsey Tanisha, Yen Laurann, Wells Robert, Leeder Stephen

机构信息

Australian Primary Health Care Research Institute and Menzies Centre for Health Policy, Australian National University, 62 Eggleston Road, Australian National University, Acton, ACT 0200, Australia.

出版信息

Aust J Prim Health. 2011;17(2):162-8. doi: 10.1071/PY10033.

Abstract

The final report of the National Health and Hospital Reform Commission (NHHRC) called for a strengthened consumer voice and empowerment. This has salience for the development of health policy concerning chronic illnesses. This paper compares the recommendations for chronic illness care made in the NHHRC final report with suggestions made by people with chronic illness and family carers of people with chronic illness in a recent Australian study. Sixty-six participants were interviewed in a qualitative research project of the Serious and Continuing Illness Policy and Practice Study (SCIPPS). Participants were people with type II diabetes mellitus, chronic obstructive pulmonary disease or chronic heart failure. Family carers were also interviewed. Content analysis was undertaken and participants' recommendations for improving care were compared with those proposed in the NHHRC final report. Many suggestions from the participants of the SCIPPS qualitative research project appeared in the NHHRC final report, including the need to improve care coordination, health literacy and the experience of Indigenous Australians. The research project also identified important issues of family carers, immigrants and people with multiple illnesses, which were not addressed in the NHHRC final report. More specific attention is needed in health reform to improve the experience of family carers, Indigenous peoples, immigrants to Australia and people with multiple illnesses. To align more closely with their needs, health reform must be explicitly informed by the voices of people with chronic illness and their family carers. The NHHRC recommendations must be supplemented with proposals that address the needs of these people for support and the problems associated with poor care coordination.

摘要

国家卫生与医院改革委员会(NHHRC)的最终报告呼吁增强消费者的话语权并赋予其权力。这对慢性病健康政策的制定具有重要意义。本文将NHHRC最终报告中关于慢性病护理的建议与澳大利亚近期一项研究中慢性病患者及其家庭护理人员提出的建议进行了比较。在一项关于严重和持续疾病政策与实践研究(SCIPPS)的定性研究项目中,对66名参与者进行了访谈。参与者包括II型糖尿病、慢性阻塞性肺疾病或慢性心力衰竭患者。还对家庭护理人员进行了访谈。进行了内容分析,并将参与者关于改善护理的建议与NHHRC最终报告中提出的建议进行了比较。SCIPPS定性研究项目参与者提出的许多建议都出现在了NHHRC最终报告中,包括改善护理协调、健康素养以及澳大利亚原住民体验的必要性。该研究项目还确定了家庭护理人员、移民和患有多种疾病的人群的重要问题,而NHHRC最终报告中并未涉及这些问题。在卫生改革中需要给予更具体的关注,以改善家庭护理人员、原住民、澳大利亚移民和患有多种疾病的人群的体验。为了更紧密地符合他们的需求,卫生改革必须明确地以慢性病患者及其家庭护理人员的声音为依据。NHHRC的建议必须辅以解决这些人群对支持的需求以及与护理协调不善相关问题的提议。

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