Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Evidence-based Synthesis Program (ESP) Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Health Serv Res. 2022 Oct;57(5):1087-1093. doi: 10.1111/1475-6773.13959. Epub 2022 Mar 4.
To identify potential orderings of primary care practice adoption of patient engagement strategies overall and separately for interpersonally and technologically oriented strategies.
We analyzed physician practice survey data (n = 71) on the adoption of 12 patient engagement strategies.
Mokken scale analysis was used to assess latent traits among the patient engagement strategies.
Three groupings of patient engagement strategies were analyzed: (1) all 12 patient engagement strategies, (2) six interpersonally oriented strategies, and (3) six technologically oriented strategies.
We did not find scalability among all 12 patient engagement strategies, however, separately analyzing the subgroups of six interpersonally and six technologically oriented strategies demonstrated scalability (Loevinger's H coefficient of scalability [range]: interpersonal strategies, H = 0.54 [0.49-0.60], technological strategies, H = 0.42 [0.31, 0.54]). Ordered patterns emerged in the adoption of strategies for both interpersonal and technological types.
Common pathways of practice adoption of patient engagement strategies were identified. Implementing interpersonally intensive patient engagement strategies may require different physician practice capabilities than technological strategies. Rather than simultaneously adopting multiple patient engagement strategies, gradual and purposeful practice adoption may improve the impact of these strategies and support sustainability.
确定初级保健实践整体采用患者参与策略的潜在顺序,以及人际和技术导向策略分别采用的潜在顺序。
我们分析了 71 名医生实践调查数据,这些数据涉及 12 种患者参与策略的采用情况。
Mokken 量表分析用于评估患者参与策略之间的潜在特征。
分析了三组患者参与策略:(1)所有 12 种患者参与策略,(2)6 种人际导向策略,(3)6 种技术导向策略。
我们没有发现所有 12 种患者参与策略之间的可扩展性,但是,分别分析人际和技术导向策略的 6 个子组显示出可扩展性(人际策略的 Loevinger's H 可扩展性系数 [范围]:H = 0.54 [0.49-0.60],技术策略,H = 0.42 [0.31, 0.54])。人际和技术类型的策略采用都出现了有序模式。
确定了患者参与策略采用的共同途径。实施人际密集型患者参与策略可能需要医生实践能力与技术策略不同。与其同时采用多种患者参与策略,逐步和有目的的实践采用可能会提高这些策略的影响,并支持可持续性。