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[医学及相关医学专业中的技能组合]

[Skill mix in medical and about medical professions].

作者信息

Kowalska-Bobko Iwona, Gałązka-Sobotka Małgorzata, Frączkiewicz-Wronka Aldona, Badora-Musiał Katarzyna, Buchelt Beata

机构信息

Uniwersytet Jagielloński, Collegium Medicum / Jagiellonian University Medical College, Kraków, Poland (Wydział Nauk o Zdrowiu, Instytut Zdrowia Publicznego / Faculty of Health Sciences, Institute of Public Health).

Uczelnia Łazarskiego / Lazarski University, Warsaw, Poland (Instytut Zarządzania w Ochronie Zdrowia / Institute of Healthcare Management).

出版信息

Med Pr. 2020 May 15;71(3):337-352. doi: 10.13075/mp.5893.00817. Epub 2020 Feb 28.

Abstract

An important problem faced by many healthcare systems is the shortage of medical staff, and in particular doctors and nurses. Their number, competences and qualifications determine the level of availability and quality of medical services. Unfortunately, the demand for medical services is increasing, along with the progressive aging of the population, as well as the increase in the incidence of chronic diseases and frequent reforms of health systems. Employee costs related to healthcare are the most burdensome for the system; therefore, based on the available resources, it is necessary to create effective teams of sector employees. This results in rationalizing employment, or providing new medical and about medical competencies to new groups of professionals, which gives rise to the skill mix phenomenon. A well-prepared and implemented skill mix contributes to improving the quality of patient care, increased patient satisfaction and better clinical outcomes. In the process of mixing of competences, the roles that have been exercised so far are being changed. While some professionals are expanding their existing roles, other employees are required to accept some aspects of the previous roles. In Poland, in order to counteract such negative trends (the shortage of doctors), changes have been introduced to increase access to medical services (e.g., nurses and midwives being vested with the right to issue prescriptions and medical ordinances, paramedics - with the right to perform medical emergency services and provide healthcare services, and physiotherapists - with the right to conduct independent physiotherapeutic visits). A new profession of a medical coordinator has also been introduced. Med Pr. 2020;71(3):337-52.

摘要

许多医疗保健系统面临的一个重要问题是医务人员短缺,尤其是医生和护士。他们的数量、能力和资质决定了医疗服务的可及性和质量水平。不幸的是,随着人口的逐渐老龄化、慢性病发病率的上升以及卫生系统的频繁改革,对医疗服务的需求在不断增加。与医疗保健相关的员工成本是该系统最沉重的负担;因此,基于可用资源,有必要组建高效的部门员工团队。这导致了就业合理化,或者为新的专业人员群体提供新的医疗及相关医疗能力,从而产生了技能组合现象。精心准备和实施的技能组合有助于提高患者护理质量、提升患者满意度并取得更好的临床效果。在能力组合的过程中,迄今为止所行使的角色正在发生变化。一些专业人员在扩大其现有角色,而其他员工则被要求接受先前角色的某些方面。在波兰,为了应对此类负面趋势(医生短缺),已进行了一些变革以增加医疗服务的可及性(例如,赋予护士和助产士开具处方和医疗指令的权利,护理人员——有权提供医疗急救服务和医疗保健服务,以及物理治疗师——有权进行独立的物理治疗问诊)。还引入了医疗协调员这一新职业。《医学实践》2020年;71(3):337 - 52。

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