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全科医疗中的质量集群:集群组织与全科医生自我报告获益之间的关联。

Quality clusters in general practice: associations between cluster organization and general practitioners' self-reported benefits.

机构信息

Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws vej 9A, 5000 Odense C, Denmark.

The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade, 1014 København K, Denmark.

出版信息

Fam Pract. 2022 Sep 24;39(5):852-859. doi: 10.1093/fampra/cmac011.

Abstract

BACKGROUND

Quality clusters were introduced as a quality improvement concept in Danish general practice in 2018. This new concept anchored quality improvement in local clusters managed by general practitioners (GPs).

OBJECTIVES

To describe the cluster organization and GPs' self-reported benefits of participating in them and explore the associations between cluster organization and self-reported benefits.

METHODS

A national survey in Danish general practice gathering information about cluster organization (cluster size, cluster meetings, participants, and content) and GPs' self-reported benefits (overall benefit, internal changes in the clinic, and improved external collaboration).

RESULTS

One hundred and eight (95%) clusters and 1,219 GPs (36%) were included. Cluster size varied from 10 to 68 GPs (34 GPs on average). Approximately 70% of GPs reported moderate to very high overall benefit from cluster participation. Most GPs experienced changes in their clinic organization (68%), drug prescriptions (78%), and patient care (77%). Collaboration was reported improved between the GPs (86%), municipality (50%), and hospital (36.2%). GPs in clusters with 3-6 planned meetings per year (odds ratio [OR] 1.9; confidence interval [CI] 1.3-2.9), mixed meeting types (OR 1.7; CI 1.2-2.4), group work (OR 1.7; CI 1.1-2.5), and use of guidelines in their meetings (OR 1.8; CI 1.3-2.4) had statistically significantly higher odds for reporting overall benefit of participating in clusters compared with GPs in clusters without these characteristics.

CONCLUSIONS

Frequent and active meetings with a relevant meeting content are positively related to GPs' perceived benefits and with improved collaboration between GPs in the clusters. There seems to be a potential for developing collaboration with other healthcare providers.

摘要

背景

质量群集作为丹麦全科医学中的一种质量改进概念于 2018 年推出。这一新概念将质量改进建立在由全科医生(GP)管理的本地群集上。

目的

描述群集组织以及 GP 参与其中的自我报告收益,并探讨群集组织与自我报告收益之间的关联。

方法

在丹麦全科医学中进行了一项全国性调查,收集了有关群集组织(群集规模、群集会议、参与者和内容)和 GP 自我报告收益(整体收益、诊所内部变化和外部合作改善)的信息。

结果

共纳入 108 个(95%)群集和 1219 名 GP(36%)。群集规模从 10 名到 68 名 GP 不等(平均 34 名 GP)。大约 70%的 GP 报告从群集参与中获得了中度到非常高的整体收益。大多数 GP 经历了诊所组织(68%)、药物处方(78%)和患者护理(77%)的变化。GP 之间的合作得到改善(86%),与市议会(50%)和医院(36.2%)的合作也得到改善。每年计划举行 3-6 次会议的群集的 GP(优势比 [OR] 1.9;置信区间 [CI] 1.3-2.9)、混合会议类型(OR 1.7;CI 1.2-2.4)、团队工作(OR 1.7;CI 1.1-2.5)和在会议中使用指南的群集(OR 1.8;CI 1.3-2.4),与没有这些特征的群集的 GP 相比,报告参与群集的整体收益的可能性更高。

结论

频繁且活跃的会议以及具有相关会议内容与 GP 感知的收益以及群集中 GP 之间的改善合作呈正相关。与其他医疗保健提供者合作似乎具有潜力。

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