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当前英格兰对“护理导航”的理解和实施情况:对英国国家医疗服务体系临床委员会的横断面研究。

Current understanding and implementation of 'care navigation' across England: a cross-sectional study of NHS clinical commissioning groups.

机构信息

Nuffield Department of Primary Care, University of Oxford, Oxford.

出版信息

Br J Gen Pract. 2019 Sep 26;69(687):e675-e681. doi: 10.3399/bjgp19X705569. Print 2019 Oct.

Abstract

BACKGROUND

Care navigation is an avenue to link patients to activities or organisations that can help address non-medical needs affecting health and wellbeing. An understanding of how care navigation is being implemented across primary care is lacking.

AIM

To determine how 'care navigation' is interpreted and currently implemented by clinical commissioning groups (CCGs).

DESIGN AND SETTING

A cross-sectional study involving CCGs in England.

METHOD

A questionnaire was sent to all CCGs inviting them to comment on who provided care navigation, the type of patients for whom care navigation was provided, how individuals were referred, and whether services were being evaluated. Responses were summarised using descriptive statistics.

RESULTS

The authors received usable responses from 83% of CCGs ( = 162), and of these >90% ( = 147) had some form of care navigation running in their area. A total of 75 different titles were used to describe the role. Most services were open to all adult patients, though particular groups may have been targeted; for example, people who are older and those with long-term conditions. Referrals tended to be made by a professional, or people were identified by a receptionist when they presented to a surgery. Evaluation of care navigation services was limited.

CONCLUSION

There is a policy steer to engaging patients in social prescribing, using some form of care navigator to help with this. Results from this study highlight that, although this type of role is being provided, its implementation is heterogeneous. This could make comparison and the pooling of data on care navigation difficult. It may also leave patients unsure about what care navigation is about and how it could help them.

摘要

背景

护理导航是将患者与能够帮助解决影响健康和福祉的非医疗需求的活动或组织联系起来的一种途径。目前,人们对护理导航在基层医疗中的实施方式缺乏了解。

目的

确定临床委托组(CCG)如何解释和当前实施“护理导航”。

设计和设置

一项涉及英格兰 CCG 的横断面研究。

方法

向所有 CCG 发送了一份问卷,邀请他们就谁提供护理导航、为谁提供护理导航、如何进行人员转介以及是否对服务进行评估发表意见。使用描述性统计对回复进行了总结。

结果

作者收到了 83%(=162)的 CCG 的有效回复,其中>90%(=147)的 CCG 在其所在地区开展了某种形式的护理导航。共有 75 种不同的标题被用来描述这个角色。大多数服务对所有成年患者开放,但也可能针对特定群体,例如老年人和患有长期疾病的人。转诊通常由专业人员进行,或者当人们到诊所就诊时,由接待员确定。对护理导航服务的评估有限。

结论

有政策指导要求让患者参与社会处方,使用某种形式的护理导航员来帮助他们。这项研究的结果表明,尽管正在提供这种类型的角色,但它的实施是多种多样的。这可能使得护理导航的比较和数据汇总变得困难。这也可能使患者不确定护理导航是什么以及它如何帮助他们。

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