Gurewich Deborah, Capitman John, Sirkin Jenna, Traje Diana
Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA 01545, USA.
J Health Care Poor Underserved. 2012 Feb;23(1):446-59. doi: 10.1353/hpu.2012.0008.
Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs.
Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance.
Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity.
In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.
现有研究对社区卫生中心（CHC）服务体系内的护理质量差异了解甚少。它们也很少告诉我们与提供特别高质量护理的社区卫生中心相关的组织条件。本研究的目的是检查与一组高绩效社区卫生中心相关的运营实践。
对八个相对于其他社区卫生中心被确定为提供高质量护理的社区卫生中心进行定性案例研究，以检查运营实践，包括促进护理获取、管理患者护理和监测绩效的系统。
出现了四个可能有助于实现高绩效的共同主题。同时，观察到各卫生中心之间存在重要差异，反映了当地环境和社区卫生中心能力的差异。
在开发有效的基于社区的护理模式时，调整护理标准以满足当地条件的需求可能很重要。
