Rasku Tuija, Kaunonen Marja, Thyer Elizabeth, Paavilainen Eija, Joronen Katja
School of Health Care and Social Services, University of Applied Sciences, Tampere, Finland.
Faculty of Social Sciences, University of Tampere, Tampere, Finland.
Scand J Caring Sci. 2019 Sep;33(3):508-521. doi: 10.1111/scs.12659. Epub 2019 Feb 8.
Since the beginning of 2000, the primary healthcare services around the globe are challenged between demands of home care and number of staff delivering it. The delivery of healthcare needs new models to reduce the costs, patient's readmission and increase their possibilities to stay at home. Several paramedicine programmes have been developed to deliver home care as an integral part of the local healthcare system. The programmes varied in nature and the concept of Community Paramedicine (CP) has not been established, demanding clarity. The aim of this review was to identify and describe the core components of CP, and identify research gaps for the further study.
A scoping review was performed using five electronic databases: Medline; CINAHL; Academic Search Premier; PubMed and the Cochrane Library for the period 2005 - June 2018. The references of articles were checked, and papers were assessed against inclusion criteria and appraised for quality.
From 803 initial articles, 21 met the criteria and were included. Inductive content analysis was carried out. The four core components of Community Paramedicine emerged (a) Community engagement, (b) Multi-agency collaboration, (c) Patient-centred prevention and (d) Outcomes of programme: cost-effectiveness and patients' experiences.
The Community Paramedicine programmes are perceived to be promising. However, Community Paramedicine research data are lacking. Further research is required to understand whether this novel model of healthcare is reducing costs, improving health and enhancing people's experiences.
自2000年初以来，全球基层医疗服务在居家护理需求和提供护理的工作人员数量之间面临挑战。医疗保健的提供需要新的模式来降低成本、减少患者再入院率，并增加他们居家的可能性。已经制定了几个辅助医疗计划，将居家护理作为当地医疗系统的一个组成部分。这些计划的性质各不相同，社区辅助医疗（CP）的概念尚未确立，需要明确。本综述的目的是确定和描述CP的核心组成部分，并确定进一步研究的差距。
使用五个电子数据库进行范围综述：Medline、CINAHL、学术搜索大全、PubMed和Cochrane图书馆，检索时间为2005年至2018年6月。检查文章的参考文献，并根据纳入标准评估论文并评估质量。
从803篇初始文章中，21篇符合标准并被纳入。进行了归纳性内容分析。社区辅助医疗的四个核心组成部分出现了：（a）社区参与，（b）多机构合作，（c）以患者为中心的预防，以及（d）计划结果：成本效益和患者体验。
社区辅助医疗计划被认为很有前景。然而，缺乏社区辅助医疗的研究数据。需要进一步研究以了解这种新型医疗模式是否正在降低成本、改善健康状况并提升人们的体验。
