正确的护理、合适的地点、恰当的时间：通过公私合营医院合作提升新南威尔士州医疗服务的及时性

Saunders Carla, Carter David J

Centre for Health Services Management, Faculty of Health, University of Technology, Jones Street, Ultimo (PO Box 222), Sydney, NSW 2007, Australia.

Faculty of Law, University of Technology Sydney, Quay Street, Ultimo (PO BOX 123), Sydney, NSW 2007, Australia. Email.

Aust Health Rev. 2017 Oct;41(5):511-518. doi: 10.1071/AH16075.

Objective The overall aim of the study was to investigate and assess the feasibility of improving the timeliness of public hospital care through a New South Wales (NSW)-wide public-private hospital partnership. Methods The study reviewed the academic and professional grey literature, and undertook exploratory analyses of secondary data acquired from two national health data repositories informing in-patient access and utilisation across NSW public and private hospitals. Results In 2014-15, the NSW public hospital system was unable to deliver care within the medically recommended time frame for over 27400 people who were awaiting elective surgery. Available information indicates that the annual commissioning of 15% of public in-patient rehabilitation bed days to the private hospital system would potentially free up enough capacity in the NSW public hospital system to enable elective surgery for all public patients within recommended time frames. Conclusions The findings of the study justify a strategic whole-of-health system approach to reducing public patient wait times in NSW and highlight the need for research efforts aimed at securing a better understanding of available hospital capacity across the public and private hospital systems, and identifying and testing workable models that improve the timeliness of public hospital care. What is known about the topic? There are very few studies available to inform public-private hospital service partnerships and the opportunities available to improve timely health care access through such partnerships. What does this paper add? This paper has the potential to open and prompt timely discussion and debate, and generate further fundamental investigation, on public-private hospital service partnerships in Australia where opportunity is available to address elective surgery wait times in a reliable and effective manner. What are the implications for practitioners? The NSW Ministry of Health and its Local Health Districts have the potential to realise a key objective, namely to deliver the 'right care, in the right place, at the right time', through the core value of collaboration, using available infrastructure.

目的本研究的总体目标是调查和评估通过新南威尔士州（NSW）范围内的公私医院合作来提高公立医院医疗及时性的可行性。方法本研究回顾了学术和专业灰色文献，并对从两个国家卫生数据存储库获取的二级数据进行了探索性分析，这些数据反映了新南威尔士州公立和私立医院的住院患者准入和利用情况。结果在2014 - 15年，新南威尔士州公立医院系统无法在医学推荐的时间框架内为超过27400名等待择期手术的患者提供治疗。现有信息表明，每年将15%的公立住院康复床位日委托给私立医院系统，有可能在新南威尔士州公立医院系统中释放足够的容量，以使所有公立患者能够在推荐的时间框架内接受择期手术。结论本研究结果证明了采取战略性的全卫生系统方法来减少新南威尔士州公立患者等待时间的合理性，并强调需要进行研究，以更好地了解公立和私立医院系统中的可用医院容量，识别和测试可行的模式，以提高公立医院医疗的及时性。关于该主题已知的信息有哪些？关于公私医院服务合作以及通过此类合作改善及时获得医疗服务机会的研究非常少。本文增加了什么内容？本文有可能开启并促使就澳大利亚的公私医院服务合作进行及时的讨论和辩论，并引发进一步的基础研究，在澳大利亚有机会以可靠和有效的方式解决择期手术等待时间问题。对从业者有何影响？新南威尔士州卫生部及其地方卫生区有潜力通过合作的核心价值，利用现有基础设施实现一个关键目标，即在正确的时间、正确的地点提供正确的护理。