利益相关者对支持在养老院中就地提供医疗服务的移动 X 光服务的看法：一项定性研究。
Stakeholders' perspectives of mobile x-ray services in support of healthcare-in-place in residential aged care facilities: a qualitative study.
机构信息
Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, SA, Australia.
Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia.
出版信息
BMC Geriatr. 2022 Aug 23;22(1):700. doi: 10.1186/s12877-022-03162-9.
BACKGROUND
There is interest in reducing avoidable emergency department presentations from residential aged care facilities (RACF). Mobile x-ray services may enable the delivery of healthcare in residential aged care facilities. Accordingly, the Australian Government in November 2019 introduced a Medicare Benefit Schedule rebate providing for a 'call-out' fee payable to radiology service providers. This study aims to understand stakeholder perspectives on the benefits of mobile x-ray services and the factors influencing their adoption by RACFs.
DESIGN, SETTING, PARTICIPANTS: Twenty-two semi-structured interviews were conducted between October 2020 and February 2021 with a range of stakeholders involved in healthcare delivery to residents: a) general practitioners; b) emergency department clinicians; c) paramedic clinicians; d) a hospital avoidance clinician; e) radiology clinicians and managers; and f) aged care clinicians and managers. Thematic analysis was conducted.
RESULTS
Mobile x-ray services were considered valuable for RACF residents. Lack of timely general practitioner in-person assessment and referral, as well as staffing deficits in residential aged care facilities, reduces optimal use of mobile x-ray services and results in potentially unnecessary hospital transfers.
CONCLUSIONS
The use of mobile x-ray services, as a hospital avoidance strategy, depends on the capacity of RACFs to provide more complex healthcare-in-place. However, this requires greater access to general practitioners for in-person assessment and referral, adequate staffing numbers and appropriately skilled nursing staff within residential aged care facilities.
背景
减少养老机构（RACF）中不必要的急诊就诊存在一定的必要性。移动 X 光服务可以使养老机构内的医疗服务得以实现。因此，澳大利亚政府于 2019 年 11 月推出了一项医疗保险福利计划回扣，为放射科服务提供商提供了“出诊”费用。本研究旨在了解利益相关者对移动 X 光服务的看法，以及影响其在 RACF 中采用的因素。
设计、设置、参与者：2020 年 10 月至 2021 年 2 月期间，与参与居民医疗服务的一系列利益相关者进行了 22 次半结构式访谈：a）全科医生；b）急诊临床医生；c）护理人员临床医生；d）医院回避临床医生；e）放射科临床医生和管理人员；f）老年护理临床医生和管理人员。进行了主题分析。
结果
移动 X 光服务被认为对 RACF 居民有价值。由于缺乏及时的全科医生亲自评估和转诊，以及养老机构人员短缺，限制了移动 X 光服务的最佳使用，并导致潜在的不必要的医院转移。
结论
作为一种避免住院的策略，移动 X 光服务的使用取决于 RACF 提供更多就地医疗服务的能力。然而，这需要更多的全科医生进行亲自评估和转诊、足够的人员数量以及在养老机构中具备适当技能的护理人员。
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