Sieber William J, Miller Benjamin F, Kessler Rodger S, Patterson Jo Ellen, Kallenberg Gene A, Edwards Todd M, Lister Zephon D
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093 USA.
Fam Syst Health. 2012 Sep;30(3):210-23. doi: 10.1037/a0029637.
Collaborative care has increased dramatically in the past decade, yet the variability in collaborative strategies and the diversity of settings in which collaboration is being implemented make it difficult to assess quality and outcomes. Therefore, three aims were addressed in the current study: (a) describe and characterize the sites in the Collaborative Care Research Network (CCRN), (b) identify factors associated with practices' self-identified collaborative care model (e.g., coordinated, integrated, care management), and (c) identify limitations of available survey data elements so as to propose additional elements for future surveys. Initial (CCRN) sites completed surveys regarding several organizational factors (e.g., setting type, size of patient population, number of behavioral health providers). Results from 39 sites showed significant heterogeneity in self-identified type of collaborative care model practiced (e.g., integrated care, coordinated care), type of practice setting (e.g., academic, federally qualified health center, military), size of clinic, and ratio of behavioral health providers to medical providers. This diversity in network site characteristics can provide a rich platform to address a number of questions regarding the current practice of collaborative care. Recommendations are made to improve future surveys to better understand elements of the patient-centered medical home and the role it may play in outcomes. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
在过去十年中,协作式医疗显著增加,但协作策略的变异性以及实施协作的环境多样性使得评估质量和结果变得困难。因此,本研究旨在实现三个目标:(a)描述和刻画协作式医疗研究网络(CCRN)中的机构,(b)识别与实践中自我认定的协作式医疗模式(如协调、整合、护理管理)相关的因素,以及(c)识别现有调查数据元素的局限性,以便为未来调查提出额外元素。CCRN的初始机构完成了关于几个组织因素(如机构类型、患者群体规模、行为健康提供者数量)的调查。来自39个机构的结果显示,在自我认定的协作式医疗模式类型(如整合式医疗、协调式医疗)、实践机构类型(如学术机构、联邦合格健康中心、军队机构)、诊所规模以及行为健康提供者与医疗提供者的比例方面存在显著异质性。网络机构特征的这种多样性可以提供一个丰富的平台,以解决许多关于当前协作式医疗实践的问题。研究提出了改进未来调查的建议,以便更好地理解以患者为中心的医疗之家的要素及其在结果中可能发挥的作用。(《心理学文摘数据库记录》(c)2012美国心理学会,保留所有权利)