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新的专业角色和患者满意度:来自三条临床路径的欧洲调查证据。

New professional roles and patient satisfaction: Evidence from a European survey along three clinical pathways.

机构信息

Università Cattolica del Sacro Cuore, Italy.

Università Niccolò Cusano, Italy.

出版信息

Health Policy. 2018 Oct;122(10):1078-1084. doi: 10.1016/j.healthpol.2018.07.020. Epub 2018 Aug 1.

DOI:10.1016/j.healthpol.2018.07.020
PMID:30227975
Abstract

This paper reports the results of an empirical analysis exploring the impact of new professions (eg a physician associate) and new professional roles on patient experiences of and satisfaction with care. A sub set of data from a patient survey conducted as part of the MUNROS programme of work was used. The overall survey aim was to describe and quantify the use of new professionals and new roles for established health care professionals other than medical doctors, in primary and secondary care sectors in three care pathways in nine European countries Ordered logit models were used to investigate the association between: (1) patient satisfaction with the last visit; (2) with their care provider; (3) with the information provided and a set of covariates explaining the involvement of new professional roles in three clinical pathways: type 2 diabetes, heart disease and breast cancer. For patients with breast cancer, high levels of satisfaction are associated with the involvement of new professions/professional roles in the provision of conditions specific education and monitoring. For patients with heart disease, the involvement of new professions/professional roles is likely to have a negative impact on satisfaction. For patients with Type 2 diabetes results are ambivalent. Patients belonging to countries experiencing innovative models of healthcare delivery and with high levels of involvement of new professions/professional roles are generally more satisfied. In conclusion, the introduction of new professions does not affect patient satisfaction negatively, therefore introducing new health professional roles is a pursuable strategy from a patient satisfaction perspective, at least for breast cancer and type 2 diabetes.

摘要

本文报告了一项实证分析的结果,该分析探讨了新职业(例如医师助理)和新专业角色对患者护理体验和满意度的影响。该分析使用了作为 MUNROS 工作计划一部分进行的患者调查的子数据集。总体调查目的是描述和量化除医生以外的既定医疗保健专业人员在初级和二级保健部门的三个护理途径中使用新专业人员和新角色的情况。有序逻辑回归模型用于研究以下三个方面之间的关联:(1)患者对上一次就诊的满意度;(2)对其护理提供者的满意度;(3)对所提供信息的满意度以及一系列解释新专业角色在三个临床途径中参与情况的协变量:2 型糖尿病、心脏病和乳腺癌。对于患有乳腺癌的患者,高水平的满意度与新职业/专业角色在提供特定疾病教育和监测方面的参与有关。对于患有心脏病的患者,新职业/专业角色的参与可能会对满意度产生负面影响。对于 2 型糖尿病患者,结果则存在矛盾。在经历创新医疗服务提供模式的国家中,以及在新职业/专业角色高度参与的情况下,患者通常更满意。总之,引入新职业不会对患者满意度产生负面影响,因此,从患者满意度的角度来看,引入新的卫生专业人员角色是一种可行的策略,至少对于乳腺癌和 2 型糖尿病是如此。

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