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使用报告卡提高大型初级保健团体实践中的 HIV 筛查率。

Using a report card to increase HIV screening in a large primary care group practice.

机构信息

Adult and Family Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California, USA

Graduate Medical Education, Kaiser Permanente Oakland Medical Center, Oakland, California, USA.

出版信息

BMJ Open Qual. 2021 Jan;10(1). doi: 10.1136/bmjoq-2020-000988.

Abstract

BACKGROUND

Despite increased efforts to promote HIV screening, a large proportion of the US population have never been tested for HIV.

OBJECTIVE

To determine whether provider education and personalised HIV screening report cards can increase HIV screening rates within a large integrated healthcare system.

DESIGN

This quality improvement study provided a cohort of primary care physicians (PCPs) a brief educational intervention and personalised HIV screening report cards with quarterly performance data.

PARTICIPANTS

Participants included a volunteer cohort of 20 PCPs in the department of adult and family medicine.

MAIN MEASURES

Per cent of empaneled patients screened for HIV by cohort PCPs compared with PCPs at the Kaiser Permanente Oakland Medical Center (KPOAK) and the non-Oakland Medical Centers in Northern California region (Kaiser Permanente Northern California (KPNC)).

KEY RESULTS

Of the 20 participating PCPs, 13 were female and 7 were male. Thirteen were internal medicine and seven family medicine physicians. The average age was 40 years and average practice experience was 9 years after residency. During the 12-month intervention, the estimated increase in HIV screening in the cohort PCP group was 2.6% as compared with 1.9% for KPOAK and 1.8% for KPNC.

CONCLUSIONS

These findings suggest that performance-related report cards are associated with modestly increased rates of HIV screening by PCPs.

摘要

背景

尽管已经加大了推广 HIV 检测的力度,但美国仍有很大一部分人从未接受过 HIV 检测。

目的

确定在一个大型综合医疗保健系统中,通过提供医疗服务者教育和个性化 HIV 筛查报告卡,能否提高 HIV 筛查率。

设计

本质量改进研究为一组初级保健医生(PCP)提供了一个简短的教育干预和个性化 HIV 筛查报告卡,其中包含季度绩效数据。

参与者

参与者包括成人和家庭医学科的 20 名志愿 PCP。

主要测量指标

与 Kaiser Permanente Oakland Medical Center(KPOAK)和北加州非奥克兰医疗中心(Kaiser Permanente Northern California(KPNC)的 PCP 相比,参加研究的 PCP 所负责的在册患者接受 HIV 筛查的百分比。

主要结果

在 20 名参与的 PCP 中,有 13 名是女性,7 名是男性。其中 13 名为内科医生,7 名为家庭医生。平均年龄为 40 岁,平均执业经验为完成住院医师规范化培训后 9 年。在 12 个月的干预期间,与 KPOAK 的 1.9%和 KPNC 的 1.8%相比,该 PCP 组 HIV 筛查的估计增长率为 2.6%。

结论

这些发现表明,与绩效相关的报告卡与 PCP 适度提高 HIV 筛查率有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f53/7797258/c5f9822ecc0d/bmjoq-2020-000988f01.jpg

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