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退伍军人健康管理局强化初级保健管理项目相关的高风险患者体验。

High-Risk Patient Experiences Associated With an Intensive Primary Care Management Program in the Veterans Health Administration.

机构信息

Health Systems Research & Development, VA Puget Sound Health Care System, Seattle, Washington (Drs Schuttner and Wong); Department of Medicine, University of Washington School of Medicine, Seattle (Dr Schuttner); VA Greater Los Angeles Healthcare System, Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Los Angeles, California (Ms Guo and Drs Jimenez and Chang); Division of General Internal Medicine, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles (Ms Guo and Drs Jimenez and Chang); Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle (Dr Wong); VA Northeast Ohio Healthcare System, Cleveland, and Case Western Reserve University School of Medicine, Cleveland, Ohio (Dr Klein); Salisbury W.G. Hefner VA Medical Center, Salisbury, North Carolina (Dr Roy); VA Center for Health Equity Research & Promotion, VA Pittsburgh Healthcare System, Pittsburgh, and Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (Dr Rosland); and Division of General Internal Medicine, Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California (Dr Chang).

出版信息

J Ambul Care Manage. 2023;46(1):45-53. doi: 10.1097/JAC.0000000000000428. Epub 2022 Aug 27.

Abstract

Intensive management programs may improve health care experiences among high-risk and complex patients. We assessed patient experience among (1) prior enrollees (n = 59) of an intensive management program (2014-2018); (2) nonenrollees (n = 356) at program sites; and (3) nonprogram site patients (n = 728), using a patient survey based on the Consumer Assessment of Healthcare Providers and Systems in 2019. Outcomes included patient ratings of patient-centered care; overall health care experience; and satisfaction with their usual outpatient care provider. In multivariate models, enrollees were more satisfied with their current provider versus nonenrollees within program sites (adjusted odds ratio 2.36; 95% confidence interval 1.15-4.85).

摘要

强化管理计划可能会改善高风险和复杂患者的医疗体验。我们评估了(1)强化管理计划的前参与者(n=59)(2014-2018 年);(2)计划点的非参与者(n=356);和(3)非计划点患者(n=728)的患者体验,使用基于 2019 年医疗保健提供者和系统消费者评估的患者调查。结果包括患者对以患者为中心的护理的评分;整体医疗体验;以及对其常规门诊护理提供者的满意度。在多变量模型中,与计划点的非参与者相比,参与者对其当前提供者的满意度更高(调整后的优势比 2.36;95%置信区间 1.15-4.85)。

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