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美国退伍军人事务部的老年患者协调护理团队:它们是如何构建的?

Geriatric Patient-Aligned Care Teams in Department of Veterans Affairs: How Are They Structured?

作者信息

Sullivan Jennifer L, Shin Marlena H, Adjognon Omonyêlé L, Shay Kenneth, Harvey Kimberly, Intrator Orna, Yaksic Enzo, Moye Jennifer, Solimeo Samantha

机构信息

Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, 150 S. Huntington Ave (152M), Boston, MA 02130, USA;

Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany St, Talbot Building, Boston, MA 02118, USA.

出版信息

Geriatrics (Basel). 2018 Sep;3(3). doi: 10.3390/geriatrics3030046. Epub 2018 Aug 1.

Abstract

Geriatric Patient-Aligned Care Teams (GeriPACT) were implemented in the Department of Veterans Affairs (VA) (i.e., Patient-Centered Medical Homes for older adults) to provide high quality coordinated care to older adults with more risk of negative health and psychosocial outcomes. The objectives of this paper are: (1) to present data on GeriPACT structural characteristics; and (2) to examine a composite measure of GeriPACT model consistency. We utilized a web survey targeting 71 physician leads resulting in a 62% response rate. We found GeriPACTs employed a range of staffing, empanelment, clinic space, and patient assignment practices. The mean value of the GeriPACT consistency measure was 2.03 (range: 1-4) and 6.3% of facilities were considered consistent to the GeriPACT model. We observed large variation in GeriPACT structure and in model consistency. More research is needed to understand how these variations are related to processes and outcomes of care.

摘要

老年患者协调护理团队(GeriPACT)已在美国退伍军人事务部(VA)实施(即针对老年人的以患者为中心的医疗之家),为健康和心理社会负面结果风险更高的老年人提供高质量的协调护理。本文的目的是:(1)展示GeriPACT结构特征的数据;(2)检验GeriPACT模型一致性的综合指标。我们对71位医生负责人进行了网络调查,回复率为62%。我们发现GeriPACT采用了一系列人员配备、患者登记、诊所空间和患者分配做法。GeriPACT一致性指标的平均值为2.03(范围:1 - 4),6.3%的机构被认为符合GeriPACT模型。我们观察到GeriPACT结构和模型一致性存在很大差异。需要更多研究来了解这些差异如何与护理过程和结果相关。

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