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运用运筹学方法规划社区姑息治疗专科团队的劳动力

Workforce Planning for Community-Based Palliative Care Specialist Teams Using Operations Research.

机构信息

Saint Mary's University, Halifax, Nova Scotia, Canada.

Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax, Nova Scotia, Canada.

出版信息

J Pain Symptom Manage. 2021 May;61(5):1012-1022.e4. doi: 10.1016/j.jpainsymman.2020.09.009. Epub 2020 Sep 15.

Abstract

CONTEXT

Many countries have aging populations. Thus, the need for palliative care will increase. However, the methods to estimate optimal staffing for specialist palliative care teams are rudimentary as yet.

OBJECTIVES

To develop a population-need workforce planning model for community-based palliative care specialist teams and to apply the model to forecast the staff needed to care for all patients with terminal illness, organ failure, and frailty during the next 20 years, with and without the expansion of primary palliative care.

METHODS

We used operations research (linear programming) to model the problem. We used the framework of the Canadian Society of Palliative Care Physicians and the Nova Scotia palliative care strategy to apply the model.

RESULTS

To meet the palliative care needs for persons dying across Nova Scotia in 2019, the model generated an estimate of 70.8 nurses, 23.6 physicians, and 11.9 social workers, a total of 106.3 staff. Thereby, the model indicated that a 64% increase in specialist palliative care staff was needed immediately, and a further 13.1% increase would be needed during the next 20 years. Trained primary palliative care providers currently meet 3.7% of need, and with their expansion are expected to meet 20.3% by 2038.

CONCLUSION

Historical, current, and projected data can be used with operations research to forecast staffing levels for specialist palliative care teams under various scenarios. The forecast can be updated as new data emerge, applied to other populations, and used to test alternative delivery models.

摘要

背景

许多国家都面临人口老龄化问题,因此对姑息治疗的需求将会增加。然而,目前评估姑息治疗专家团队最佳人员配置的方法还很基础。

目的

开发一种基于人群需求的社区姑息治疗专家团队劳动力规划模型,并应用该模型预测在未来 20 年内,在不扩大初级姑息治疗的情况下,以及在扩大初级姑息治疗的情况下,需要多少人员来照顾所有患有终末期疾病、器官衰竭和虚弱的患者。

方法

我们使用运筹学(线性规划)来对问题进行建模。我们应用了加拿大姑息治疗医师学会和新斯科舍省姑息治疗战略的框架来应用该模型。

结果

为了满足 2019 年新斯科舍省所有临终患者的姑息治疗需求,该模型估计需要 70.8 名护士、23.6 名医生和 11.9 名社工,总共需要 106.3 名员工。因此,模型表明,目前急需增加 64%的姑息治疗专家人员,在未来 20 年内还需要增加 13.1%。经过培训的初级姑息治疗提供者目前满足了 3.7%的需求,预计到 2038 年,这一比例将扩大到 20.3%。

结论

历史、当前和预测数据可与运筹学一起用于预测各种情况下姑息治疗专家团队的人员配置水平。随着新数据的出现,可以对预测结果进行更新,应用于其他人群,并用于测试替代的交付模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3314/7490249/f6a8229d9666/gr1_lrg.jpg

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