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[基层医疗中的社区议程分析及其实施相关因素]

[Analysis of community agendas in primary care and factors associated with their implementation].

作者信息

Domínguez García Marta, Pola-García Marina, Oliván Blázquez Bárbara, Lahoz Bernad Isabel, Lou Alcaine María Luz, Benedé Azagra Carmen Belén

机构信息

Servicio Aragonés de Salud, Zaragoza, España; Grupo GIIS011, Instituto Investigación Sanitaria Aragón, Zaragoza, España; Grupo Aragonés de Investigación en Atención Primaria B21_20R, Gobierno de Aragón, Zaragoza, España.

Servicio Aragonés de Salud, Zaragoza, España; Grupo GIIS011, Instituto Investigación Sanitaria Aragón, Zaragoza, España.

出版信息

Gac Sanit. 2022 Nov 5;37:102257. doi: 10.1016/j.gaceta.2022.102257. eCollection 2023.

Abstract

OBJECTIVE

To describe the community agendas created by the Aragonese Primary Care Teams (PCT), to analyze the characteristics of said PCT, and to explore factors related to their implementation.

METHOD

Descriptive observational study of the community agendas and the Aragonese PCT that have created them since the implementation of the Aragonese Community Care Strategy (ACCS) in 2016 until March 2021. Bivariate and multivariate analysis of the characteristics of these PCT that have created the agenda with respect to those who have not developed it.

RESULTS

75 of the 123 Aragonese PCT (61%) have created the community agenda. 74.7% of them also have an active Health Council. 45 of the 75 agendas are of the advanced type, with 41 PCT that had carried out the zone health diagnosis and 28 PCT that made asset recommendations. It was observed how the creation of the community agenda is related to being a PCT belonging to a semi-urban basic health zone (odds ratio [OR]: 3.02; 95% confidence interval [95% CI]: 1.22-7.47; p=0.017) and that at least one professional would have received specific training (OR: 5.29; 95% CI: 1.09-25.72; p=0.039).

CONCLUSIONS

The community agenda is a tool that supports the development of community care for PCT. The training provided by the ACCS has been shown to be key to the development of the agendas, and this work must continue, with special emphasis on the PCT belonging to rural or urban basic health zones, since they are the ones that are experiencing the greatest difficulties.

摘要

目的

描述阿拉贡初级保健团队(PCT)制定的社区议程,分析这些PCT的特征,并探讨与其实施相关的因素。

方法

对自2016年阿拉贡社区护理战略(ACCS)实施至2021年3月期间制定社区议程的阿拉贡PCT及其社区议程进行描述性观察研究。对已制定议程的PCT与未制定议程的PCT的特征进行双变量和多变量分析。

结果

123个阿拉贡PCT中有75个(61%)制定了社区议程。其中74.7%还设有活跃的健康委员会。75个议程中有45个属于高级类型,41个PCT进行了区域健康诊断,28个PCT提出了资产建议。研究发现,社区议程的制定与属于半城市基本健康区的PCT有关(优势比[OR]:3.02;95%置信区间[95%CI]:1.22 - 7.47;p = 0.017),且至少有一名专业人员接受过特定培训(OR:5.29;95%CI:1.09 - 25.72;p = 0.039)。

结论

社区议程是支持PCT开展社区护理的一种工具。ACCS提供的培训已被证明是议程制定的关键,这项工作必须继续,特别要关注属于农村或城市基本健康区的PCT,因为它们面临的困难最大。

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