家庭医疗诊所是否通过医疗改革推动的组织变革改善了医疗服务的可及性？
Are Family Medicine Clinics Improving Access to Care through Organizational Changes Driven by Healthcare Reform?
机构信息
Associate Clinical Professor, Faculty of Medicine, Department of Family Medicine and Emergency Medicine University of Montreal, Montreal, QC.
Assistant Clinical Professor, Faculty of Medicine, Department of Family Medicine and Emergency Medicine, University of Montreal, Montreal, QC.
出版信息
Healthc Policy. 2022 Aug;18(1):46-59. doi: 10.12927/hcpol.2022.26905.
PURPOSE
This observational descriptive study reports organizational changes after the last reform in 18 family medicine units (FMUs) affiliated with the University of Montreal in Québec.
METHOD
Two self-administered surveys on access to care were administered to FMU directors between December 2016 and January 2017, and in August 2018.
RESULTS
Between surveys, the number of registered patients increased substantially. All clinics recruited new patients, and most offered walk-in services (89%) and moved toward an advanced access scheduling model (83%). For licensed practical nurses, there was a median increase from 0 to 3 and for nurse clinicians, from 2 to 3, that helped the development of collaborative teamwork.
CONCLUSION
Despite the added teaching mission, the response of the FMU network has been dynamic, has adapted to the major changes and has continued to actively improve access to care for their communities. Challenges still remain regarding work on key priorities for improving access management.
目的
本观察性描述性研究报告了魁北克省蒙特利尔大学附属的 18 个家庭医学单位（FMU）在最近一次改革后的组织变化。
方法
2016 年 12 月至 2017 年 1 月和 2018 年 8 月，向 FMU 主任发放了两份关于获得医疗服务的自我管理调查问卷。
结果
两次调查之间，注册患者数量大幅增加。所有诊所都招募了新患者，大多数提供了门诊服务（89%），并向高级预约安排模式（83%）发展。对于执业护士，中位数从 0 增加到 3，对于护理临床医生，从 2 增加到 3，这有助于协作团队的发展。
结论
尽管增加了教学任务，但 FMU 网络的反应是积极的，适应了重大变化，并继续积极改善其社区的医疗服务获取。在改善获取管理的重点工作方面仍存在挑战。
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