Tomaschek Rebecca, Lampart Patricia, Scheel-Sailer Anke, Gemperli Armin, Merlo Christoph, Essig Stefan
Center for Primary and Community Care, Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, CH.
Swiss Paraplegic Centre, Guido A. Zäch Str. 1, 6207 Nottwil, CH.
Int J Integr Care. 2022 Aug 8;22(3):4. doi: 10.5334/ijic.5970. eCollection 2022 Jul-Sep.
Coordination of healthcare professionals seems to be particularly important for patients with complex chronic disease, as they present a challenging interplay of conditions and symptoms. As one solution, to counteract or prevent this, improving collaboration between general practitioners (GPs) and specialists has been the aim of studies by linking or coordinating their services along the continuum of care. This scoping review summarises role distributions and components of this collaboration that have potential for improvement for the care of patients with complex chronic conditions.
Scoping review as a knowledge synthesis for components of collaboration and role distributions between medical specialists and GPs in intervention studies. The PubMed database was searched for literature from 2010-2020.
Literature search and reference screening generated 2,174 articles. 30 articles originating from 22 unique projects were included in our synthesis. In the interventions to improve collaboration, the GP is most commonly in charge of patient management and extends the scope of practice. The specialist provides support when needed. Clear definition of roles, resources for knowledge transfer and education from specialists are commonly utilised interventions. Typically, combinations of process and system changes addressing communication and coordination issues are applied. Most interventions improve provider and patient satisfaction, health outcomes, and reduce care fragmentation.
This review showed that interventions to improve collaboration between GPs and medical specialists seem promising. Further efforts should be made to test and apply the findings systematically in broad clinical practice.
对于患有复杂慢性病的患者而言，医疗保健专业人员之间的协调似乎尤为重要，因为这类患者的病情和症状相互作用，极具挑战性。作为一种解决方案，为了应对或预防这种情况，通过在连续护理过程中联系或协调全科医生（GP）和专科医生的服务，改善他们之间的合作一直是研究的目标。本范围综述总结了这种合作的角色分布和组成部分，这些方面在改善复杂慢性病患者的护理方面仍有提升潜力。
采用范围综述作为知识综合方法，梳理干预研究中医疗专科医生和全科医生之间合作的组成部分和角色分布。在PubMed数据库中检索2010年至2020年的文献。
文献检索和参考文献筛选共产生2174篇文章。我们的综述纳入了来自22个独立项目的30篇文章。在改善合作的干预措施中，全科医生最常负责患者管理并扩大执业范围。专科医生在需要时提供支持。明确角色定义、知识转移资源以及专科医生的教育是常用的干预措施。通常会采用解决沟通和协调问题的流程和系统变革相结合的方式。大多数干预措施提高了医疗服务提供者和患者的满意度、改善了健康结局，并减少了护理碎片化。
本综述表明，改善全科医生和医疗专科医生之间合作的干预措施似乎很有前景。应进一步努力在广泛的临床实践中系统地测试和应用这些研究结果。
