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辅助卫生专业人员的扩展角色:证据的更新系统评价。

Extended roles for allied health professionals: an updated systematic review of the evidence.

机构信息

School of Health and Sports Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia ; Cluster for Health Improvement, University of the Sunshine Coast, Sippy Downs, QLD, Australia ; Queensland Health, Brisbane, QLD, Australia.

School of Health and Sports Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia ; Cluster for Health Improvement, University of the Sunshine Coast, Sippy Downs, QLD, Australia.

出版信息

J Multidiscip Healthc. 2014 Oct 13;7:479-88. doi: 10.2147/JMDH.S66746. eCollection 2014.

Abstract

BACKGROUND

Internationally, health care services are under increasing pressure to provide high quality, accessible, timely interventions to an ever increasing aging population, with finite resources. Extended scope roles for allied health professionals is one strategy that could be undertaken by health care services to meet this demand. This review builds upon an earlier paper published in 2006 on the evidence relating to the impact extended scope roles have on health care services.

METHODS

A systematic review of the literature focused on extended scope roles in three allied health professional groups, ie, physiotherapy, occupational therapy, and speech pathology, was conducted. The search strategy mirrored an earlier systematic review methodology and was designed to include articles from 2005 onwards. All peer-reviewed published papers with evidence relating to effects on patients, other professionals, or the health service were included. All papers were critically appraised prior to data extraction.

RESULTS

A total of 1,000 articles were identified by the search strategy; 254 articles were screened for relevance and 21 progressed to data extraction for inclusion in the systematic review.

CONCLUSION

Literature supporting extended scope roles exists; however, despite the earlier review calling for more robust evaluations regarding the impact on patient outcomes, cost-effectiveness, training requirements, niche identification, or sustainability, there appears to be limited research reported on the topic in the last 7 years. The evidence available suggests that extended scope practice allied health practitioners could be a cost-effective and consumer-accepted investment that health services can make to improve patient outcomes.

摘要

背景

在国际上,医疗保健服务面临着越来越大的压力,需要为不断增长的老龄化人口提供高质量、可及、及时的干预措施,而资源却是有限的。扩大卫生专业人员的服务范围是医疗保健服务满足这一需求的一种策略。本综述是在 2006 年发表的一篇关于扩大服务范围对医疗服务影响的证据的早期论文的基础上进行的。

方法

对三个卫生专业群体(即物理治疗、职业治疗和言语病理学)的扩展范围角色进行了文献的系统综述。搜索策略反映了早期的系统综述方法,旨在包括 2005 年以后发表的文章。所有具有与患者、其他专业人员或卫生服务相关的效果证据的同行评审发表论文都包括在内。在提取数据之前,所有论文都进行了批判性评估。

结果

通过搜索策略确定了 1000 篇文章;对 254 篇文章进行了相关性筛选,21 篇文章进入数据提取阶段,纳入系统综述。

结论

有支持扩大服务范围的文献;然而,尽管早期的综述呼吁对患者结局、成本效益、培训要求、利基识别或可持续性的影响进行更有力的评估,但在过去 7 年中,关于这一主题的研究报告似乎有限。现有证据表明,扩大服务范围的实践使卫生专业人员成为一种具有成本效益和消费者接受的投资,卫生服务可以通过这种投资来改善患者的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a3e/4206389/9b658f0c3d24/jmdh-7-479Fig1.jpg

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