Palladino Raffaele, More Ash, Greenfield Geva, Anokye Nana, Pigott Elizabeth, Willis Tony, Edward Gregg, Majeed Azeem, Kong Wing May
Department of Primary Care and Public Health, Imperial College School of Public Health, Imperial College, London, the UK.
Department of Public Health, University "Federico II" of Naples, Naples, Italy.
Int J Integr Care. 2022 Apr 5;22(2):4. doi: 10.5334/ijic.5956. eCollection 2022 Apr-Jun.
Diabetes foot ulceration (DFU) presents an enormous burden to those living with diabetes and to the local health systems and economies. There is an increasing interest in implementing integrated care models to enhance the quality of care for people living with diabetes and related complications and the value of co-production approaches to achieve sustainable change. This paper aims to describe the evaluation methodology for the North West London (NWL) Diabetes Foot Care Transformation project.
A mixed methods design including: i) a quasi-experimental quantitative analysis assessing the impact of the implementation of the local secondary care multi-disciplinary diabetes foot team clinics on service utilisation and clinical outcomes (amputations and number of healed patients); ii) a phenomenological, qualitative study to explore patient and staff experience; and iii) a within-trial cost-effectiveness analysis (pre and post 2017) to evaluate the programme cost-effectiveness.
Demonstrating the impact of multidisciplinary, integrated care models and the value of co-production approaches is important for health providers and commissioners trying to improve health outcome. Evaluation is also needed to identify strategies to overcome barriers which might have reduced the impact of the programme and key elements for improvement.
糖尿病足溃疡（DFU）给糖尿病患者以及当地卫生系统和经济带来了巨大负担。人们越来越关注实施综合护理模式，以提高糖尿病患者及其相关并发症患者的护理质量，以及共同生产方法对于实现可持续变革的价值。本文旨在描述伦敦西北部（NWL）糖尿病足护理转型项目的评估方法。
采用混合方法设计，包括：i）一项准实验性定量分析，评估当地二级护理多学科糖尿病足团队诊所的实施对服务利用和临床结果（截肢和愈合患者数量）的影响；ii）一项现象学定性研究，以探索患者和工作人员的体验；iii）一项试验内成本效益分析（2017年前后），以评估该项目的成本效益。
证明多学科综合护理模式的影响以及共同生产方法的价值，对于试图改善健康结果的医疗服务提供者和专员来说非常重要。还需要进行评估，以确定克服可能降低项目影响的障碍的策略以及改进的关键要素。
