Chesterton Lorna, Stephens Melanie, Clark Andrew, Ahmed Anya
School of Health and Society, University of Salford, Salford, UK.
Disabil Rehabil. 2021 Feb;43(3):317-323. doi: 10.1080/09638288.2019.1628314. Epub 2019 Jun 18.
The patient hotel model was developed in Northern Europe as a response to increased demand for health and wellbeing services. According to current literature the patient hotel model is a concept of care provision which combines non-acute hospital care with hospitality to afford patients/guests increased satisfaction and security whilst benefitting from evidenced based care.
OBJECTIVE(S): This paper evaluates the concept of the patient hotel model. It presents the findings of a systematic review of existing literature evaluating the benefits such a model can bring to healthcare services and reports on the efficacy in terms of cost to health service providers, and health outcomes to patients/guests. The authors' aimed to complete a meta-analysis of the data, but were unable to, due to the diversity in the descriptions, service provisions, and client group.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to conduct and report this systematic review. In order to focus the research question, the PICO (Population; Intervention; Comparison and Outcome) framework was used to develop a strategy in literature searching, to ensure systematic rigor.
DATA SOURCES/REVIEW METHODS: Cochrane Database of Systematic Reviews, OVID MEDLINE, CINAHL, Embase, ScienceDirect, Web of Science, and Scopus databases were used to search for randomized controlled trials, quasi experimental studies, quantitative and qualitative studies conducted between January 1st 2008 and August 9th, 2018, published in a peer reviewed journal in English or which provided an abstract in English. Citation searches and hand searches were also conducted.
8,693 papers were retrieved and from abstract screening 68 full-text articles were assessed for eligibility by applying an inclusion and exclusion criteria. Seven articles were retained for quality assessment. Methodological rigor was appraised using accepted criteria for the evaluation of research. On appraisal, one systematic review, one Randomized Clinical Trial, two qualitative studies, one quantitative survey, one retrospective analysis of services, and one comparative analysis paper were included for data synthesis. The functionality of the patient hotel model differed across the six countries that reported on them in the included studies, from oncology care, medical care, post-acute rehabilitation and perioperative care. The studies included in this review broadly focused on the themes of patient experience and/or cost, with the intention of informing future service provision. Studies relating to cost efficacy looked at the potential financial savings which could be realized through adopting the patient hotel model. The appraised studies found positive benefits of adopting the patient hotel model, both in terms of cost and patient satisfaction. One study explored the role of nurses in a patient hotel.
The lack of consistent definition, diversity in the descriptions, service provisions, and client groups meant that the results could only be systematically reviewed and not synthesized into a meta-analysis. The inconsistencies in labeling and description also have implications for the review process, as studies adopting more abstract classification of the patient hotel model may not have been included in the review. On balance, the appraised evidence appears to suggest that there are positive benefits to patients, nurses and healthcare providers. However further research of greater rigor is needed to provide a better understanding of these outcome measures. Implications for rehabilitation Patient hotels have particular relevance to the field of rehabilitation as they have a strong ethos of promoting self-care and independence, facilitated through greater freedom and family involvement. The patient hotel model has the potential to impact healthcare provision on the global stage, but there is no universal definition, making evidence evaluation difficult. The patient hotel model combines the concepts of health and hospitality and could potentially provide a cost-effective alternative to healthcare, with positive outcomes for patient experience as well as patient health. There is a need to explore new systems of care delivery which provide increased patient satisfaction, and a seamless continuum of care at the acute and primary care interface. This paper examines the patient hotel model of care, and its merits in terms of care provision, patient satisfaction and service efficiency, contributing to the embryonic literature in this field.
患者酒店模式在北欧发展起来,以应对对健康和福祉服务日益增长的需求。根据当前文献,患者酒店模式是一种护理提供概念,它将非急性医院护理与热情款待相结合,以使患者/客人获得更高的满意度和安全感,同时受益于循证护理。
本文评估患者酒店模式的概念。它展示了对现有文献进行系统综述的结果,该综述评估了这种模式能给医疗服务带来的益处,并报告了对医疗服务提供者的成本效益以及对患者/客人的健康结果。作者旨在对数据进行荟萃分析,但由于描述、服务提供和客户群体的多样性而未能进行。
采用系统评价和荟萃分析的首选报告项目(PRISMA)声明来进行和报告这项系统综述。为了聚焦研究问题,使用PICO(人群、干预措施、对照和结果)框架制定文献检索策略,以确保系统严谨性。
数据来源/综述方法:使用Cochrane系统评价数据库、OVID MEDLINE、CINAHL、Embase、ScienceDirect、科学网和Scopus数据库,搜索2008年1月1日至2018年8月9日期间发表在同行评审英文期刊上或提供英文摘要的随机对照试验、准实验研究、定量和定性研究。还进行了引文检索和手工检索。
检索到8693篇论文,通过摘要筛选,根据纳入和排除标准评估了68篇全文文章的 eligibility。保留7篇文章进行质量评估。使用公认的研究评估标准评估方法严谨性。经评估,纳入一篇系统综述、一篇随机临床试验、两篇定性研究、一篇定量调查、一篇服务回顾性分析和一篇比较分析论文进行数据合成。在所纳入研究中报告该模式的六个国家里,患者酒店模式的功能各不相同,涵盖肿瘤护理、医疗护理、急性后康复和围手术期护理。本综述纳入的研究广泛聚焦于患者体验和/或成本主题,旨在为未来的服务提供提供信息。与成本效益相关的研究考察了通过采用患者酒店模式可能实现的潜在财务节省。经评估的研究发现采用患者酒店模式在成本和患者满意度方面都有积极益处。一项研究探讨了护士在患者酒店中的作用。
缺乏一致的定义、描述、服务提供和客户群体的多样性意味着结果只能进行系统综述,而不能综合成荟萃分析。标签和描述的不一致也对综述过程有影响,因为采用对患者酒店模式更抽象分类的研究可能未被纳入综述。总体而言,经评估的证据似乎表明对患者、护士和医疗服务提供者有积极益处。然而,需要更严谨的进一步研究以更好地理解这些结果指标。对康复的启示 患者酒店与康复领域特别相关,因为它们有通过更大的自由度和家庭参与来促进自我护理和独立性的强烈理念。患者酒店模式有可能在全球舞台上影响医疗服务提供,但没有通用定义,这使得证据评估困难。患者酒店模式将健康和热情款待的概念结合起来,有可能为医疗保健提供一种具有成本效益的替代方案,对患者体验以及患者健康都有积极结果。需要探索新的护理提供系统,以提高患者满意度,并在急性和初级护理界面提供无缝的连续护理。本文考察了患者酒店护理模式及其在护理提供、患者满意度和服务效率方面的优点,为该领域的初步文献做出了贡献。