Müller Beate S, Falkenhagen Nadine, Wilke Dennis, Gerlach Ferdinand M, Erler Antje
Goethe-Universität Frankfurt am Main, Zentrum für Gesundheitswissenschaften, Institut für Allgemeinmedizin, Frankfurt am Main, Deutschland.
Goethe-Universität Frankfurt am Main, Zentrum für Gesundheitswissenschaften, Institut für Allgemeinmedizin, Frankfurt am Main, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2018 Apr;131-132:53-59. doi: 10.1016/j.zefq.2018.01.010. Epub 2018 Feb 24.
The combination of an ageing population and unequal distribution of healthcare capacity between rural and urban regions requires the development of innovative healthcare models, especially in rural areas, thus increasing the need to involve community representatives. The aim of this study was to ascertain the need for support and advice among municipalities and family doctors planning and implementing regional projects to ensure the provision of healthcare, and to develop a support and consultancy service on that basis.
Using semi-structured telephone interviews, 16 local representatives of the target groups (representatives from rural districts, mayors of rural municipalities and communities, doctors in private practice) were asked to identify the kind of support and advice they needed. The interviews were evaluated using the framework approach, a form of qualitative content analysis, and the results used to develop modules of a support and consultancy service. We discussed and finalized the concept during several workshops involving different representatives of the target groups (another 36 general practitioners, 19 mayors and representatives from rural districts).
After taking into account the expressed need for advice and support, the developed consultancy service included the following modules: local situation/needs analysis, financial support options (e. g., grant application), concept/project development (including presentation of best practice examples), networks, assessment and evaluation, junior staff recruitment and introduction to other experts (for legal or IT-related advice, mediation, etc.).
The study showed that local representatives have a substantial need for advice and support for which no nationwide consultancy service is yet available. Future practice tests should establish the extent to which local participants and projects can benefit from the consultancy service we have developed.
人口老龄化以及城乡地区医疗保健能力分布不均的状况，需要创新医疗模式，尤其是在农村地区，因此越来越需要社区代表的参与。本研究的目的是确定在规划和实施区域医疗保健项目以确保医疗服务提供的市和家庭医生中，对支持和建议的需求，并在此基础上开发一种支持和咨询服务。
通过半结构化电话访谈，询问了16名目标群体的当地代表（农村地区代表、农村市和社区市长、私人执业医生）他们需要何种支持和建议。使用框架法（一种定性内容分析形式）对访谈进行评估，并将结果用于开发支持和咨询服务模块。我们在有目标群体不同代表（另外36名全科医生、19名市长和农村地区代表）参加的几次研讨会上讨论并最终确定了该概念。
在考虑到所表达的对建议和支持的需求后，所开发的咨询服务包括以下模块：当地情况/需求分析、资金支持选项（例如，拨款申请）、概念/项目开发（包括最佳实践案例展示）、网络、评估与评价、初级员工招聘以及向其他专家介绍（获取法律或信息技术相关建议、调解等）。
该研究表明，地方代表对建议和支持有很大需求，而目前尚无全国性的咨询服务。未来的实践测试应确定地方参与者和项目能在多大程度上从我们所开发的咨询服务中受益。
