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卫生系统中患者出院计划的实施要求:伊朗的一项定性研究

Implementation Requirements for Patient Discharge Planning in Health System: A qualitative study in Iran.

作者信息

Gholizadeh Masumeh, Janati Ali, Delgoshaei Bahram, Gorji Hasan Abulghasem, Tourani Sogand

机构信息

Departement of Health Services Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Ethiop J Health Sci. 2018 Mar;28(2):157-168. doi: 10.4314/ejhs.v28i2.7.

Abstract

BACKGROUND

Effective discharge planning plays a vital role in care continuity and integrated care. Identifying and providing infrastructures for discharge planning can reduce avoidable hospital readmissions and finally lead to improvement of quality of care. The current study aimed to identify the requirements of discharge planning from the perspective of professionals in the health system of Iran.

METHODS

For the purposes of this qualitative study, semi-structured interviews and sessions of focus group discussions with experts in the field were conducted. The data were analyzed using a thematic and framework analyses method. The study population was 51 participants including health policy makers, hospital and health managers, faculty members, nurses, practitioners, community medicine specialists and other professionals of the Ministry of Health andMedical Education (MOHME).

RESULTS

According to the control knobs (health reforms levels), recruitments of effective hospital discharge planning were divided into four areas, behavior (ofpolicy makers, service providers, recipients services), organization, payment and financing and regulation (themes), in which there were 3, 7, 2 and 3 sub-themes respectively. Based on the findings of the interviews, they were categorized into the following main themes: behavior (policy makers, providers and patients), organizational change, financing and payment system and rules and regulations.

CONCLUSIONS

According to the results of the present study, it appears to be essential for health managers and policy makers to pay attention to essential requirements of effective discharge planning.

摘要

背景

有效的出院计划在护理连续性和综合护理中起着至关重要的作用。确定并提供出院计划的基础设施可以减少可避免的医院再入院情况,并最终提高护理质量。本研究旨在从伊朗卫生系统专业人员的角度确定出院计划的要求。

方法

为了进行这项定性研究,对该领域的专家进行了半结构化访谈和焦点小组讨论。使用主题和框架分析方法对数据进行了分析。研究对象为51名参与者,包括卫生政策制定者、医院和卫生管理人员、教职员工、护士、从业者、社区医学专家以及卫生和医学教育部(MOHME)的其他专业人员。

结果

根据控制旋钮(卫生改革水平),有效的医院出院计划的招募分为四个领域,即行为(政策制定者、服务提供者、接受者服务)、组织、支付和融资以及监管(主题),其中分别有3、7、2和3个子主题。根据访谈结果,它们被归类为以下主要主题:行为(政策制定者、提供者和患者)、组织变革、融资和支付系统以及规章制度。

结论

根据本研究结果,卫生管理人员和政策制定者关注有效出院计划的基本要求似乎至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0348/6016349/6cacae62b474/EJHS2802-0157Fig1.jpg

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