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[全科医生对利用通信技术的整合式照护的认知:对“地平线2020”资助项目“POLYCARE”焦点小组的二次分析]

[General practitioners' perception of integrated care using communication technologies: a secondary analysis of a focus group of the Horizon 2020 funded project POLYCARE].

作者信息

Fischer Stefanie, Schrimpf Anne, Herget Sabine, Lippmann Stefan, Coenen Martin, Heiland Nils Henning, Panknin Christina, Weckbecker Klaus, Bleckwenn Markus

机构信息

Selbstständige Abteilung für Allgemeinmedizin, Medizinische Fakultät der Universität Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Deutschland.

Univ.-Klinikum Bonn, Institut f. Klin. Chemie u. Klinische Pharmakologie, Bonn, Deutschland.

出版信息

MMW Fortschr Med. 2022 Jul;164(Suppl 7):16-22. doi: 10.1007/s15006-022-1133-3.

Abstract

BACKGROUND

Integrated healthcare models (IC) have the objective of reducing the costs of an increased use of health service as well as the strong sectoral fragmentation of the German health care system. However, no national approach has been implemented in primary care to date.

METHOD

Ten GPs from the Cologne/Bonn district (60% male; Ø age = 52 years [35-65]) were invited to a focus group in 2016. The interview was part of the Horizon 2020 funded POLYCARE study. A semi-structured guideline was used to assess feasibility of the POLYCARE study protocol. GPs also provided information about previous experience with and attitudes toward IC models and the relevant information and communication technologies (ICT), such as home-monitoring or communication software. This information was analyzed using a transcending secondary analysis to evaluate conditions for their successful implementation.

RESULTS

Participants reported little experience with IC and ICT. However, they reported being open to both and seeing potential for time savings, better networking opportunities, and increased quality of care for their patients. The integration of social services was considered as a chance of alleviating the burden of socio-medical tasks. Barriers to the introduction of IC and ICT were seen in the initial time investment, the lack of legal structures, the concern about overabundant data, and the susceptibility to failure.

CONCLUSION

The nationwide expansion of social services as well as ICT that is easy to use, less susceptible to failure, and compatible with existing structures show great potential for relieving GPs. Future research should address the concerns - such as financial and time expenses of introducing IC and ICT - of GPs by systematic investigation in long-term studies. The provision of an additional legal basis that is regulating the respective remuneration models as well as the rights and obligations of all parties, IC and ICT can play a greater role in future patient care.

摘要

背景

整合式医疗模式(IC)旨在降低医疗服务使用增加带来的成本,以及德国医疗体系严重的部门分割问题。然而,迄今为止,初级医疗领域尚未实施全国性的方法。

方法

2016年,邀请了来自科隆/波恩地区的10名全科医生(60%为男性;平均年龄 = 52岁[35 - 65岁])参加焦点小组讨论。此次访谈是由“地平线2020”资助的POLYCARE研究的一部分。使用半结构化指南评估POLYCARE研究方案的可行性。全科医生还提供了他们以前对IC模式以及相关信息和通信技术(ICT)(如家庭监测或通信软件)的经验和态度方面的信息。使用超越性二次分析对这些信息进行分析,以评估其成功实施的条件。

结果

参与者表示对IC和ICT的经验很少。然而,他们表示对两者都持开放态度,并认为有可能节省时间、获得更好的网络机会以及提高患者护理质量。社会服务的整合被视为减轻社会医疗任务负担的一个契机。引入IC和ICT的障碍在于初始时间投入、缺乏法律框架、对数据过多的担忧以及易失败性。

结论

在全国范围内扩展社会服务以及易于使用、不易失败且与现有结构兼容的ICT,对于减轻全科医生的负担具有巨大潜力。未来的研究应通过长期研究中的系统调查来解决全科医生的担忧,如引入IC和ICT的财务和时间成本等。提供一个额外的法律基础,规范各自的薪酬模式以及各方(IC和ICT)的权利和义务,IC和ICT在未来的患者护理中可以发挥更大的作用。

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