Duhoux Arnaud, Dufour Émilie, Sasseville Martin, Laroche Dominique, Contandriopoulos Damien
Faculty of nursing, University of Montreal, CA.
Charles-Le Moyne Research Center, CA.
Int J Integr Care. 2022 Apr 27;22(2):8. doi: 10.5334/ijic.5945. eCollection 2022 Apr-Jun.
Integrated Primary Care Teams (IPCTs) have four key characteristics (intensive interdisciplinary practice; advanced nursing practice with an expanded role; group practice; increased proximity and availability) aimed at strengthening primary care in Quebec, Canada. The purpose of this paper is to examine the care experience over time of patients who have an IPCT as their primary source of care.
We used a quasi-experimental longitudinal design based on a pre-and-post administered survey at a 2-year interval without a control group. We measured patient-reported accessibility, continuity, comprehensiveness, responsiveness and outcomes of care.
Results showed that patients who were newly registered with an IPCT had a significant increase in reported care experience, whereas patients who have been registered with an IPCT for 2 years prior to the first round of data collection had already high reported care experience that was maintained over time. Moreover, linear regression models showed statistically significant different increases in the dimensions of care experience by site and patients' characteristics.
Our results suggest that the IPCT model is tailored to the needs of its target populations, resulting in improved Patient Reported Experience Measures. These results imply that broader implementation of innovative and flexible community-based care models should be considered by policymakers.
综合初级保健团队(IPCTs)具有四个关键特征(强化跨学科实践;角色扩展的高级护理实践;团队协作;增加医患亲近度和可及性),旨在加强加拿大魁北克省的初级保健。本文的目的是研究以IPCTs作为主要医疗来源的患者随时间推移的就医体验。
我们采用了一种准实验性纵向设计,基于每隔两年进行一次的前后问卷调查,且未设对照组。我们测量了患者报告的可及性、连续性、全面性、响应性和护理结果。
结果显示,新注册到IPCTs的患者报告的就医体验有显著提升,而在第一轮数据收集前已在IPCTs注册两年的患者,其报告的就医体验原本就很高且随时间得以维持。此外,线性回归模型显示,不同地点和患者特征在就医体验维度上的提升存在统计学显著差异。
我们的结果表明,IPCT模式是根据其目标人群的需求定制的,从而改善了患者报告的体验指标。这些结果意味着政策制定者应考虑更广泛地实施创新且灵活的社区护理模式。