Fowler Tara Trudnak, Aiyelawo Kimberley Marshall, Frazier Chantell, Holden Craig, Dorris Joseph
Altarum Institute, Ann Arbor, MI, USA.
Defense Health Agency, Falls Church, VA, USA.
J Patient Exp. 2020 Dec;7(6):1234-1240. doi: 10.1177/2374373520925275. Epub 2020 May 19.
This study compared TRICARE, the health care program of the United States Department of Defense Military Health System, beneficiaries in CenteringPregnancy, an enhanced prenatal care model, to women in individual prenatal care within the same military treatment facility. Maternity patient experience ratings from May 2014 to February 2016 were compiled from the TRICARE Outpatient Satisfaction Survey. Centering patients had 1.91 higher odds of being satisfied with ( < .01, 95% CI = 1.2-3.1) than women in individual care. Specifically, the measure found Centering patients to have 2.00 higher odds of being satisfied than women in individual care ( < .01, 95% CI = 1.2-3.3). There were no other statistically significant differences between cohorts. Qualitative responses indicate most Centering patients surveyed had good experiences, appreciated the structure and communication with others, and would recommend the program. Providers identified command/leadership support, dedicated space, and buy-in from all staff as important factors for successful implementation. Enhanced prenatal care models may improve access to and experiences with care. Program evaluation will be important as the military health system continues to implement such programs.
本研究将美国国防部军事卫生系统的医疗保健项目TRICARE的受益人、采用强化产前护理模式的“孕期集中护理”项目中的女性，与同一军事治疗机构中接受个体产前护理的女性进行了比较。2014年5月至2016年2月的产妇患者体验评分来自TRICARE门诊满意度调查。与接受个体护理的女性相比，参加“孕期集中护理”项目的患者满意度更高的几率高出1.91倍（P<0.01，95%置信区间=1.2-3.1）。具体而言，该测量发现参加“孕期集中护理”项目的患者满意度更高的几率比接受个体护理的女性高出2.00倍（P<0.01，95%置信区间=1.2-3.3）。各队列之间没有其他统计学上的显著差异。定性回答表明，大多数接受调查的“孕期集中护理”项目患者都有良好的体验，赞赏其结构以及与他人的沟通，并会推荐该项目。提供者认为，指挥部/领导层的支持、专用空间以及所有工作人员的认同是成功实施该项目的重要因素。强化产前护理模式可能会改善医疗服务的可及性和体验。随着军事卫生系统继续实施此类项目，项目评估将很重要。
