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伙伴关系与成果:卫生与社会保健合作是否满足使用者和照顾者的需求?

Partnership working and outcomes: do health and social care partnerships deliver for users and carers?

机构信息

Institute for Research and Innovation in Social Services (IRISS), Glasgow, UK.

出版信息

Health Soc Care Community. 2013 Nov;21(6):623-33. doi: 10.1111/hsc.12050. Epub 2013 May 9.

Abstract

Working in partnership, both across social care and health and with service users, has been a persistent theme of the health and social care modernisation agenda in the United Kingdom. Despite a relatively underdeveloped evidence base, the development of health and social care partnerships has continued to feature in recent policy and legislative initiatives in the United Kingdom. At the same time there has been a major shift in focus towards the outcomes that support services deliver. A central question remaining is whether the policy initiatives driving the development of health and social care partnerships are delivering improved outcomes, particularly the outcomes valued by people who use services. This article outlines research designed to explore this issue across 15 health and social care partnerships in England and Scotland, building from previous research by the Social Policy Research Unit based at the University of York. It sought to assess the extent to which health and social care partnerships deliver the outcomes that people who use services value, and to determine the features of partnership working associated with the delivery of these outcomes. A robust outcomes framework was defined, which provided the basis for interviews with those receiving support from partnerships. Working with three user-researcher organisations, interviews were completed with 230 individuals in 2006. On the basis of this, some service users were able to identify features of partnership that particularly contributed to improved outcomes. These included continuity of staff and sufficient staff and a range of resources, including the availability of long-term and preventative services. Given the definitional and methodological complexity surrounding partnership working, and the challenges of attribution, the study faced some limitations in its ability to make wider inferences about partnership and outcomes. A theory of change should be employed in future studies of this type.

摘要

在英国,合作——无论是在社会关怀和卫生领域内部,还是与服务使用者之间——一直是卫生和社会关怀现代化议程的一个持续主题。尽管相关证据基础相对薄弱,但卫生和社会关怀伙伴关系的发展仍然是英国近期政策和立法倡议的重点。与此同时,重点也发生了重大转变,转向支持服务提供的结果。一个悬而未决的核心问题是,推动卫生和社会关怀伙伴关系发展的政策举措是否带来了更好的结果,特别是服务使用者看重的结果。本文概述了旨在探索英格兰和苏格兰 15 个卫生和社会关怀伙伴关系的研究,这是约克大学社会政策研究单位之前的研究基础上进行的。它试图评估卫生和社会关怀伙伴关系在多大程度上提供了服务使用者看重的结果,并确定与提供这些结果相关的伙伴关系工作的特征。定义了一个稳健的结果框架,为与从伙伴关系中获得支持的人进行访谈提供了基础。与三个用户研究组织合作,2006 年完成了对 230 个人的访谈。在此基础上,一些服务使用者能够确定伙伴关系中特别有助于改善结果的特征。这些特征包括工作人员的连续性和充足的工作人员以及一系列资源,包括长期和预防性服务的可用性。考虑到伙伴关系工作的定义和方法学复杂性,以及归因的挑战,该研究在其对伙伴关系和结果进行更广泛推断的能力方面存在一些限制。在这种类型的未来研究中,应该采用变革理论。

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