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[关于墨西哥高专科医疗护理的一些观察]

[Some observations on high specialty medical care in Mexico].

作者信息

García Moreno Juan, Tirado-Gómez Laura Leticia, Rojas-Russell Mario Enrique, Escamilla Santiago Ricardo A, Pacheco-Domínguez Reyna Lizzete, López-Cervantes Malaquías

机构信息

Facultad de Medicina, Universidad Nacional Autónoma de México.

出版信息

Gac Med Mex. 2013 Mar-Apr;149(2):175-82.

Abstract

OBJECTIVES

To put forth the concept of highly specialized medical care, in agreement with the nature of its practice, and evaluate the feasibility of creating a support service network.

METHODS

Qualitative study of the current practice and requirements for 39 selected medical specialties, using the technique of focused groups of experts in each specialty. In accordance with the "Grounded Theory", variables were systematized and categorized and then compared in order to identify relationships between categories and link them to consensus testimonial references. On the basis of the characteristics of each kind of practice, one key expert integrated and validated service portfolios.

RESULTS

We developed an integrated a concept for highly specialize medical care with 39 operational catalogs of those diagnoses that belong to each specialty, along with catalogs of the resources required by each specialty.

CONCLUSIONS

Highly specialized care is a desirable model for clinical practice, but does not constitute a different level of care. Currently, medical practice is constrained by the lack of well-defined boundaries and scarcity of resources in order to be conceptualized as high specialty. It is therefore more convenient to strengthen the concept of third level of care in order to identify opportunities for the establishment of high specialty areas that will in turn serve as the focal points for medical innovation.

摘要

目的

根据高度专业化医疗服务的实际情况提出其概念,并评估创建支持服务网络的可行性。

方法

采用对各专业领域专家进行焦点小组访谈的技术,对39个选定医学专业的当前实践和需求进行定性研究。依据“扎根理论”,对变量进行系统化和分类,然后进行比较,以确定类别之间的关系,并将其与共识性的证明参考资料相联系。基于每种实践的特点,由一名关键专家整合并验证服务组合。

结果

我们制定了一个高度专业化医疗服务的综合概念,其中包括属于各专业的39种诊断操作目录,以及各专业所需资源目录。

结论

高度专业化医疗服务是临床实践中一个理想的模式,但并不构成一个不同的医疗水平。目前,医疗实践受到缺乏明确界定的边界和资源稀缺的限制,难以被概念化为高度专业化。因此,更适宜强化三级医疗服务的概念,以确定建立高度专业化领域的机会,这些领域将反过来成为医学创新的焦点。

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