重新构建塞浦路斯医疗服务体系。

Re-engineering the Cypriot healthcare service system.

机构信息

University College London, Medical Research Council Clinical Trials Unit, 90 High Holborn, London, WC1V 6LJ, UK.

King's College London Centre for Implementation Science, Institute of Institute of Psychiatry, Psychology & Neuroscience, Health Service & Population Research Department, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.

出版信息

BMC Health Serv Res. 2020 Apr 7;20(1):293. doi: 10.1186/s12913-020-5048-3.

DOI:10.1186/s12913-020-5048-3

PMID:32264910

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7137859/

Abstract

BACKGROUND

The Cypriot healthcare system has undergone a number of major transformations since the induction of the Republic of Cyprus in the European Union over 10 years ago. Currently Cyprus is undergoing a major reform, namely the introduction of a primary care driven national healthcare system. The aim of the study was to assess the existing state of training, support, quality, guidelines and infrastructure towards a better healthcare system in Cyprus.

METHODS

This is a mixed-methods study combining statistical data until October 2016 and workshop discussions delivered in Cyprus in November 2015. We used anonymised data provided: (1a) by the Cyprus Medical Association of all registered medical doctors up to October 2016; (1b); by the Ministry of Health (MoH) Health Monitoring Unit up to October 2016; (2) during a workshop organised with representatives from the Royal College of Physicians, the European Commission and the Health Insurance Organization.

RESULTS

The gender ratio of men over women is disproportionate, with over 85% of the medical doctors undertaking their training in Greece, Eastern Europe and neighbouring countries, while the current record does not hold a relevant specialty information for 4 out of 10 doctors. The results show lack of statutory inspection systems, application of revalidation principles or implementation of peer-review clinical services on the island. There are eight proposed recommendations made by the workshop participants towards the transformation of the Cypriot healthcare system and the development of the Cyprus Quality Improvement Institute. These are aimed at addressing gaps in quality of care, adherence to clinical guidelines and implementation of audits, development of doctors' revalidation and peer-review of clinical services, accreditation of service implementation, establishment of a statutory inspection system as well as the set-up of an incentives program as part of the general healthcare system (GHS) of Cyprus.

CONCLUSIONS

Current efforts for the implementation of the new GHS in Cyprus call for adequate training and support of the medical workforce, transparent and safer quality of care provision through the implementation of clinical guidelines and capacity-building infrastructure.

摘要

背景

自塞浦路斯共和国加入欧盟超过 10 年以来，塞浦路斯的医疗体系经历了多次重大变革。目前，塞浦路斯正在进行重大改革，即引入以初级保健为导向的国家医疗体系。本研究旨在评估塞浦路斯在培训、支持、质量、指南和基础设施方面为建立更好的医疗体系所做的努力。

方法

这是一项混合方法研究，结合了截至 2016 年 10 月的统计数据和 2015 年 11 月在塞浦路斯举行的研讨会讨论。我们使用了匿名数据：（1a）由塞浦路斯医学协会提供的截至 2016 年 10 月所有注册医生的数据；（1b）由卫生部卫生监测股提供的截至 2016 年 10 月的数据；（2）在与皇家内科医师学院、欧盟委员会和健康保险组织代表组织的研讨会上收集的数据。

结果

男女医生比例严重失调，超过 85%的医生在希腊、东欧和邻国接受培训，而目前的记录中，10 名医生中有 4 名没有相关的专业信息。研究结果表明，岛上缺乏法定检查系统、应用再认证原则或实施同行评审临床服务。研讨会参与者提出了八项建议，旨在推动塞浦路斯医疗体系的转型和塞浦路斯质量改进研究所的发展。这些建议旨在解决医疗质量、临床指南依从性和审计实施、医生再认证和临床服务同行评审、服务实施认证、建立法定检查系统以及建立激励计划等方面的差距，这些都是塞浦路斯一般医疗体系（GHS）的一部分。