Department of Preventive Medicine, Northwestern University, 680 North Lake Shore Drive Suite 1220, Chicago, IL 60611 USA.
Transl Behav Med. 2011 Dec;1(4):511-2. doi: 10.1007/s13142-011-0087-2.
The fourth column on Evidence-Based Behavioral Medicine presents a synopsis of the systematic review by Trivedi et al. (2011) comparing the quality of medical care in veterans affairs (VA) and non-VA settings. Thirty-six studies were included in the synthesis. Each article was given a grade of A, B, or C based on the six elements of high-quality studies. Most studies assessing adherence to recommended processes of care showed that the VA performed better that non-VA sites. Similar rates were found for both groups in studies that assessed risk-adjusted mortality. This implies that a greater adherence to evidence-based processes (e.g., preventive care, medication prescription, and referral) did not result in decreased morbidity and mortality. It is established that engaging in evidence-based practices and processes improves short-term intermediate endpoints (e.g., patient satisfaction). Future research is needed to test whether short-term benefits of evidence-based care processes connect to mortality outcomes.
循证行为医学第四栏介绍了 Trivedi 等人（2011 年）对退伍军人事务部（VA）和非 VA 环境中医疗保健质量进行的系统评价的概要。该综合分析共纳入 36 项研究。根据高质量研究的六个要素，每篇文章都被评为 A、B 或 C 级。大多数评估循证护理推荐流程依从性的研究表明，VA 比非 VA 地点表现更好。在评估风险调整死亡率的研究中，两组的比率相似。这意味着对循证流程（例如，预防保健、药物处方和转诊）的更高依从性并没有导致发病率和死亡率降低。已确定，参与循证实践和流程可以改善短期中间终点（例如，患者满意度）。需要进一步研究来检验循证护理流程的短期效益是否与死亡率结果相关。
