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变革的资金支持:新西兰药剂师对社区药房服务协议的看法与经历

Funding for change: New Zealand pharmacists' views on, and experiences of, the community pharmacy services agreement.

作者信息

Kinsey Hannah, Scahill Shane, Bye Lynne, Harrison Jeff

机构信息

School of Pharmacy, University of Nottingham, Nottingham, UK.

School of Management, Massey University, Albany, Auckland, New Zealand.

出版信息

Int J Pharm Pract. 2016 Dec;24(6):379-389. doi: 10.1111/ijpp.12266. Epub 2016 Apr 28.

Abstract

OBJECTIVE

To explore pharmacist's views on the shift in ethos, funding and service delivery model introduced through the New Zealand's Community Pharmacy Services Agreement (CPSA).

METHODS

A purposive sampling approach drew pharmacists from a matrix who were then contacted via telephone and invited to be interviewed. Semistructured interviews were conducted face-to-face with community pharmacists (n = 17) across urban and rural New Zealand. An interview schedule exploring 12 subject areas was used to facilitate discussion and determine pharmacist's views and understanding of the CPSA. The interviews were recorded and transcribed verbatim and a general inductive approach was taken to identifying emergent themes.

KEY FINDINGS

Key themes that emerged were: pharmacists supported the philosophy behind the CPSA, pharmacists understanding of the CPSA, implementing CPSA-related services, perceived impact on patient outcomes and future sustainability of the CPSA. Overall, pharmacists supported the alignment of funding with patient-centred services, but pharmacy owners reported difficulty understanding the funding model, resulting in uncertainty over income. Several pharmacists believed the quality of care offered had not changed, while others found their attitudes towards care had evolved. All pharmacists communicated an increase in their workload and many perceived the sustainability of the CPSA to be linked to its ability to financially sustain community pharmacies.

CONCLUSIONS

The majority of pharmacists believed in the philosophy of the CPSA, but expressed concerns over funding, workload and benefits for patients. Future research is required to determine generalisability of these findings, investigate patient perspectives and assess the effect of the CPSA on patient outcomes.

摘要

目的

探讨药剂师对通过新西兰社区药房服务协议(CPSA)引入的理念、资金和服务提供模式转变的看法。

方法

采用目的抽样法,从一个矩阵中抽取药剂师,然后通过电话联系并邀请他们接受访谈。对新西兰城乡各地的社区药剂师(n = 17)进行了面对面的半结构化访谈。使用一份探索12个主题领域的访谈提纲来促进讨论,并确定药剂师对CPSA的看法和理解。访谈进行了录音并逐字转录,采用一般归纳法来识别新出现的主题。

主要发现

出现的关键主题有:药剂师支持CPSA背后的理念、药剂师对CPSA的理解、实施与CPSA相关的服务、对患者结局的感知影响以及CPSA的未来可持续性。总体而言,药剂师支持资金与以患者为中心的服务保持一致,但药房业主表示难以理解资金模式,导致收入不确定。几位药剂师认为所提供护理的质量没有变化,而其他人则发现他们对护理的态度有所转变。所有药剂师都表示工作量有所增加,许多人认为CPSA的可持续性与其在财务上维持社区药房的能力有关。

结论

大多数药剂师相信CPSA的理念,但对资金、工作量和患者受益表示担忧。需要进一步研究以确定这些发现的普遍性,调查患者的观点,并评估CPSA对患者结局的影响。

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