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初级保健中的家访:日常实践中的内容与组织。一项横断面研究的研究方案。

Home visits in primary care: contents and organisation in daily practice. Study protocol of a cross-sectional study.

作者信息

Voigt Karen, Bojanowski Stefan, Taché Stephanie, Voigt Roger, Bergmann Antje

机构信息

Department of General Practice/Medical Clinic III, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.

Department of General Practice/Medical Clinic III, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany Department of Family and Community Medicine, University California San Francisco, San Francisco, California, USA.

出版信息

BMJ Open. 2016 Feb 26;6(2):e008209. doi: 10.1136/bmjopen-2015-008209.

Abstract

INTRODUCTION

Medical care of homebound patients by home visits is an integral part of primary care in Germany and other industrialised countries. Owing to the sociodemography and changes in the health system, the need for home visits is projected to increase rather than decrease. Our study will provide information on content and organisation of home visits. This evidence is needed to assure sufficient medical care for homebound patients. Germany is one of the European nations with highest proportions of elderly age groups, so that our results will be indicative for other European countries with comparable organisation of primary care.

METHODS AND ANALYSIS

This cross-sectional study is conducted over a period of 12 months. All home visits of each participating family practice are documented within a 1-week time period. The anonymous documentation of home visits is carried out by the family practitioner or medical assistant conducting the home visit. All Saxon Family practitioners received study information and were personally invited to participate in our study. Almost 303 (of 2677) family practitioners expressed their interest to participate to generate data on the content and organisational characteristics of home visits. Data analysis of more than 4000 home visits will take into account several patient-related and system-related parameters. Descriptive and multivariate analysis will be carried out by using non-parametric methods. Regarding expected cluster structure of the data, a multilevel analysis will be necessary.

ETHICS AND DISSEMINATION

The study received ethical approval by the Ethical Commission of the TU Dresden and adheres to the Declaration of Helsinki. Considering that the results of our project will be indicative for ageing societies with comparable organisation of primary care, we will publish them in international open access journals concerned with healthcare and primary care research and disseminate them by a final symposium and at national/international scientific events.

摘要

引言

上门访视居家患者的医疗服务是德国和其他工业化国家初级医疗服务不可或缺的一部分。由于社会人口统计学因素和卫生系统的变化,上门访视的需求预计会增加而非减少。我们的研究将提供有关上门访视内容和组织的信息。为确保为居家患者提供充分的医疗服务,需要这些证据。德国是老年人口比例最高的欧洲国家之一,因此我们的研究结果将对其他初级医疗服务组织类似的欧洲国家具有指示性意义。

方法与分析

这项横断面研究为期12个月。每个参与的家庭医生诊所的所有上门访视都在1周时间内进行记录。上门访视的匿名记录由进行访视的家庭医生或医疗助理完成。所有萨克森州的家庭医生都收到了研究信息,并被亲自邀请参与我们的研究。(在2677名家庭医生中)近303名表示有兴趣参与,以生成有关上门访视内容和组织特征的数据。对4000多次上门访视的数据分析将考虑几个与患者相关和与系统相关的参数。将使用非参数方法进行描述性和多变量分析。鉴于数据预期的聚类结构,有必要进行多层次分析。

伦理与传播

该研究获得了德累斯顿工业大学伦理委员会的伦理批准,并遵循《赫尔辛基宣言》。鉴于我们项目的结果将对初级医疗服务组织类似的老龄化社会具有指示性意义,我们将在关注医疗保健和初级医疗服务研究的国际开放获取期刊上发表研究结果,并通过最终研讨会以及在国家/国际科学活动中进行传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a966/4769432/4fe0646a5c1f/bmjopen2015008209f01.jpg

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