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以患者为中心的牙科之家:质量评估、改善和整合的标准化定义。

The patient-centered dental home: A standardized definition for quality assessment, improvement, and integration.

机构信息

Public Policy Center, Preventive and Community Dentistry, University of Iowa, Iowa City, Iowa.

Preventive and Community Dentistry and Public Policy Center, University of Iowa, Iowa City, Iowa.

出版信息

Health Serv Res. 2019 Apr;54(2):446-454. doi: 10.1111/1475-6773.13067. Epub 2018 Oct 10.

Abstract

OBJECTIVE

To develop the first standardized definition of the patient-centered dental home (PCDH).

DATA SOURCES/STUDY SETTING: Primary data from a 55-member national expert panel and public comments.

STUDY DESIGN

We used a modified Delphi process with three rounds of surveys to collect panelists' ratings of PCDH characteristics and open-ended comments. The process was supplemented with a 1-month public comment period.

DATA COLLECTION/EXTRACTION METHODS: We calculated median ratings, analyzed consensus using the interpercentile range adjusted for symmetry, and qualitatively evaluated comments.

PRINCIPAL FINDINGS

Forty-nine experts (89%) completed three rounds and identified eight essential PCDH characteristics, resulting in the following definition: "The patient-centered dental home is a model of care that is accessible, comprehensive, continuous, coordinated, patient- and family-centered, and focused on quality and safety as an integrated part of a health home for people throughout the life span."

CONCLUSIONS

This PCDH definition provides the foundation for developing measures for research, care improvement, and accreditation and is aligned with the patient-centered medical home. Consensus among a broad national expert panel-including provider, payer, and accreditation stakeholder organizations and experts in medicine, dentistry, and quality measurement-supports the definition's usability and its potential to facilitate medical-dental primary care integration.

摘要

目的

制定首个以患者为中心的牙科之家(PCDH)的标准化定义。

资料来源/研究范围:来自 55 名国家专家组成员的原始数据和公开意见。

研究设计

我们使用经过修改的 Delphi 流程进行了三轮调查,以收集专家组对 PCDH 特征的评分和开放式意见。该过程辅以为期一个月的公开意见征求期。

资料收集/提取方法:我们计算了中位数评分,使用经对称调整的百分位区间分析了共识,并对意见进行了定性评估。

主要发现

49 名专家(89%)完成了三轮调查,确定了八项基本的 PCDH 特征,由此得出的定义为:“以患者为中心的牙科之家是一种以患者和家庭为中心、以质量和安全为重点的医疗模式,它是健康之家的一个组成部分,贯穿于人的一生,具有可及性、全面性、连续性、协调性。”

结论

该 PCDH 定义为研究、护理改善和认证制定措施提供了基础,与以患者为中心的医疗之家相一致。包括提供者、付款人和认证利益相关者组织以及医学、牙科和质量测量方面的专家在内的广泛的国家专家组达成共识,支持该定义的可用性及其促进医疗-牙科初级保健整合的潜力。

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