Blume A, Snellgrove B, Steinert T
Klinik für Psychiatrie und Psychotherapie I der Universität Ulm, Weissenau, ZfP Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
Nervenarzt. 2019 Jan;90(1):40-44. doi: 10.1007/s00115-018-0621-2.
The objective of this study was to systematically review the international literature with respect to significant links between staffing levels or qualification on the one hand and patient-related outcomes on the other. Of the initial 7778 abstracts identified by means of a complex search strand in PubMed and CINAHL, 51 could finally be included in a qualitative synthesis. A total of nine different patient-related outcome categories with significant associations on an at least ordinally scaled level were distinguished. None of the studies included had a (quasi-)experimental research design. Despite, in some instances, high numbers of cases at multiple sites and efforts to control obvious confounding variables by regression analysis, no evidence-based conclusions for health policy or clinical practice can be drawn from the available observational studies. There is therefore a considerable need for prospective randomized or at least quasi-experimental studies also as accompanying research on novel models of financing.
本研究的目的是系统回顾国际文献，探讨一方面人员配备水平或资质与另一方面患者相关结局之间的重要联系。通过在PubMed和CINAHL中进行复杂检索，最初识别出7778篇摘要，最终51篇可纳入定性综合分析。总共区分出九个不同的与患者相关的结局类别，它们在至少有序尺度水平上存在显著关联。纳入的研究均无（准）实验研究设计。尽管在某些情况下多个地点有大量病例，且通过回归分析努力控制明显的混杂变量，但从现有的观察性研究中无法得出基于证据的卫生政策或临床实践结论。因此，迫切需要进行前瞻性随机研究或至少准实验研究，作为新型融资模式配套研究的一部分。
