Professor, Centre for Health Services and Health Research, University of British Columbia, School of Nursing, University of British Columbia, Vancouver, BC.
Associate Professor, Department of Family Medicine, University of Ottawa, Ottawa, ON.
Healthc Policy. 2021 Nov;17(2):19-37. doi: 10.12927/hcpol.2021.26659.
The aim of this work was to show the feasibility of providing a comprehensive portrait of regional primary care performance.
The TRANSFORMATION study used a mixed-methods concurrent study design where we analyzed survey data and case studies. Data were collected in British Columbia, Ontario and Nova Scotia. Patient's Medical Home (PMH) pillar scores were created by calculating mean clinic-level scores across regions. Scores and qualitative themes were compared.
Participation included 86 practices (n = 1,929 patients; n = 117 clinicians). Regions had differential attainment towards PMH orientation with respect to infrastructure; community adaptiveness and accountability; and patient and family partnered care. The lowest PMH attainment for all regions were observed in connected care; accessible care; measurement, continuous quality improvement and research; and training, education and continuing professional development.
Comprehensive performance reporting that draws on multiple data sources in primary care is possible. Regional portraits highlighting many of the key pillars of a PMH approach to primary care show that despite differences in policy contexts, achieving a PMH remains elusive.
本研究旨在展示提供全面的区域初级保健绩效描述的可行性。
TRANSFORMATION 研究采用混合方法的同期研究设计，对调查数据和案例研究进行分析。数据采集于不列颠哥伦比亚省、安大略省和新斯科舍省。通过计算各区域诊所的平均得分来创建患者的医疗之家（PMH）支柱评分。对评分和定性主题进行比较。
共有 86 家诊所（n=1929 名患者；n=117 名临床医生）参与了研究。在基础设施、社区适应性和问责制以及患者和家庭伙伴关系方面，各区域在 PMH 定位方面的达成度存在差异。所有区域的 PMH 得分最低的方面包括：连贯的护理、可及性护理、衡量、持续质量改进和研究以及培训、教育和持续专业发展。
在初级保健中使用多种数据源进行综合绩效报告是可行的。区域概况突出了 PMH 方法的许多关键支柱，表明尽管政策背景存在差异，但实现 PMH 仍然难以实现。
