Parker Victoria A, Lemak Christy Harris
Department of Health Policy & Management, School of Public Health, Boston University, MA, USA.
Adv Health Care Manag. 2011;11:149-83. doi: 10.1108/s1474-8231(2011)0000011010.
As health care delivery becomes increasingly focused on patient-centered models, interventions such as patient navigation that have the potential to improve care coordination garner interest from health care managers and clinicians. The ability to understand how and to what extent patient navigation is successful in addressing coordination issues, however, is hampered by multiple definitions, vague boundaries, and different contextual implementations of patient navigation. Using a systematic review strategy and classification method, we review both the conceptual and empirical literature regarding navigation in multiple clinical contexts. We then describe and conceptualize variation in how patient navigation has been defined, implemented, and theorized to affect outcomes. This review suggests that patient navigation varies along multiple dimensions and that the variation is related to differing resources, constraints, and goals. We propose a conceptual model to frame further research and suggest that research in this area must carefully account for this variation in order to accurately assess the benefits of patient navigation and provide actionable knowledge for managers.
随着医疗服务越来越注重以患者为中心的模式，诸如患者导航等有潜力改善医疗协调的干预措施引起了医疗管理者和临床医生的兴趣。然而，由于患者导航存在多种定义、界限模糊以及不同的情境实施方式，了解患者导航在解决协调问题方面如何成功以及在多大程度上成功的能力受到了阻碍。我们采用系统综述策略和分类方法，回顾了多个临床背景下有关导航的概念性和实证性文献。然后，我们描述并概念化了患者导航在定义、实施和理论化以影响结果方面的差异。这篇综述表明，患者导航在多个维度上存在差异，并且这种差异与不同的资源、限制和目标有关。我们提出一个概念模型来为进一步的研究提供框架，并建议该领域的研究必须仔细考虑这种差异，以便准确评估患者导航的益处并为管理者提供可操作的知识。
