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等待中的痛苦:对澳大利亚持续性疼痛服务提供情况的系统调查。

Waiting in pain: a systematic investigation into the provision of persistent pain services in Australia.

机构信息

Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, VIC.

出版信息

Med J Aust. 2012 Apr 2;196(6):386-90. doi: 10.5694/mja12.10140.

Abstract

OBJECTIVES

To document and describe outpatient persistent pain management services in Australia.

DESIGN, PARTICIPANTS AND SETTING: Systematic survey conducted between 1 December 2008 and 31 January 2010 of 57 services providing outpatient care to adult clients with persistent pain, plus five specialised paediatric services throughout Australia.

MAIN OUTCOME MEASURES

Service structure, including funding processes; activity, including client numbers, access to specialised services (inpatient care, pain relief interventions); waiting times; and use of allied-health-professional-based pain management programs.

RESULTS

Of 68 services identified, 57 participated in the study. The median waiting time from referral receipt to initial clinical assessment for a publicly funded outpatient adult pain management service was 150 days, compared with 38.5 days for a privately funded service (P<0.05). There was substantial variability among providers in range of services offered, including provision and duration of allied-health pain management programs. The level of service provision for children and rural patients is notably lower than that reported for urban adult constituents.

CONCLUSIONS

Persistent pain management services are currently unable to meet service requirements adequately, and waiting times are more prolonged for publicly funded than privately funded services. Greater service provision is required in rural areas and for children.

摘要

目的

记录和描述澳大利亚的门诊持续性疼痛管理服务。

设计、参与者和设置:2008 年 12 月 1 日至 2010 年 1 月 31 日期间,对澳大利亚 57 家为持续性疼痛的成年患者提供门诊护理的服务机构,外加 5 家专门的儿科服务机构,进行了系统性调查。

主要结果测量

服务结构,包括资金流程;活动,包括患者数量、获得专门服务(住院治疗、止痛干预)的机会;等候时间;以及利用以辅助医疗专业人员为基础的疼痛管理计划的情况。

结果

在确定的 68 个服务机构中,有 57 个参与了研究。从收到转介到对公共资助的成人疼痛管理门诊服务进行初步临床评估的中位等候时间为 150 天,而私人资助服务的等候时间为 38.5 天(P<0.05)。各服务提供者提供的服务范围存在很大差异,包括提供和持续时间不同的辅助医疗疼痛管理计划。为儿童和农村患者提供的服务水平明显低于为城市成年患者提供的服务水平。

结论

持续性疼痛管理服务目前无法充分满足服务需求,公共资助服务的等候时间比私人资助服务的等候时间更长。农村地区和儿童需要更多的服务提供。

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