德国初级保健实践中慢性病信息交换网络：一项横断面研究。

Information exchange networks for chronic diseases in primary care practices in Germany: a cross-sectional study.

机构信息

Department of General Practice and Health Services Research, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

出版信息

BMC Prim Care. 2022 Mar 28;23(1):56. doi: 10.1186/s12875-022-01649-3.

DOI:10.1186/s12875-022-01649-3

PMID:35346050

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8958478/

Abstract

BACKGROUND

Coordination of care requires information exchange between health workers. The structure of their information exchange networks may influence the quality and efficiency of healthcare delivery. The aim of this study was to explore and classify information exchange networks in primary care for patients with chronic diseases in Germany.

METHODS

A cross-sectional study was carried out between 2019 and 2021. As part of a larger project on coordination of care, this study focused on information exchange in practice teams regarding patients with type 2 diabetes (DM), coronary heart disease (CHD) and chronic heart failure (CHF). Social network analysis was applied to determine the number of connections, density and centralization for each of the health conditions for each of the practices. On the basis of the descriptive findings, we developed typologies of information exchange networks in primary care practices.

RESULTS

We included 153 health workers from 40 practices, of which 25 practices were included in the social network analysis. Four types of information exchange structures were identified for the three chronic diseases: highly connected networks with low hierarchy, medium connected networks with medium hierarchy, medium connected networks with low hierarchy and lowly connected networks. Highly connected networks with low hierarchy were identified most frequently (18 networks for DM, 17 for CHD and 14 for CHF). Of the three chronic conditions, information sharing about patients with DM involved the most team members. Information exchange outside the family practice took place mainly with nurses and pharmacists.

CONCLUSIONS

This study identified four types of information exchange structures, which provides a practical tool for management and improvement in primary care. Some practices had few information transfer connections and could hardly be considered a network.

TRIAL REGISTRATION

We registered the study prospectively on 7 November 2019 at the German Clinical Trials Register (DRKS, www.drks.de ) under ID no. DRKS00019219.

摘要

背景

医疗保健协调需要医护人员之间的信息交流。他们的信息交流网络结构可能会影响医疗保健的质量和效率。本研究旨在探索和分类德国慢性病患者初级保健中的信息交流网络。

方法

这是一项在 2019 年至 2021 年期间进行的横断面研究。作为协调医疗保健项目的一部分，该研究重点关注关于 2 型糖尿病（DM）、冠心病（CHD）和慢性心力衰竭（CHF）患者的实践团队中的信息交流。社会网络分析用于确定每个实践中每种健康状况的连接数量、密度和集中化程度。基于描述性发现，我们开发了初级保健实践中信息交换网络的分类法。

结果

我们纳入了来自 40 个实践的 153 名医护人员，其中 25 个实践被纳入社会网络分析。针对三种慢性病，确定了四种信息交换结构类型：具有低层次的高度连接网络、具有中等层次的中等连接网络、具有低层次的中等连接网络和低度连接网络。具有低层次的高度连接网络最为常见（DM 有 18 个网络，CHD 有 17 个网络，CHF 有 14 个网络）。在三种慢性病中，关于 DM 患者的信息共享涉及最多的团队成员。家庭医生以外的信息交流主要与护士和药剂师进行。