Faculty of Medicine, Osaka University, Suita, Osaka 565-0871, Japan.
Independent Researcher, Kita-ku, Kyoto 603-8233, Japan.
Int J Environ Res Public Health. 2022 Dec 1;19(23):16113. doi: 10.3390/ijerph192316113.
Various tools to measure patient complexity have been developed. Primary care physicians often deal with patient complexity. However, their usefulness in primary care settings is unclear. This study explored complexity measurement tools in general adult and patient populations to investigate the correlations between patient complexity and outcomes, including health-related patient outcomes, healthcare costs, and impacts on healthcare providers. We used a five-stage scoping review framework, searching MEDLINE and CINAHL, including reference lists of identified studies. A total of 21 patient complexity management tools were found. Twenty-five studies examined the correlation between patient complexity and health-related patient outcomes, two examined healthcare costs, and one assessed impacts on healthcare providers. No studies have considered sharing information or action plans with multidisciplinary teams while measuring outcomes for complex patients. Of the tools, eleven used face-to-face interviews, seven extracted data from medical records, and three used self-assessments. The evidence of correlations between patient complexity and outcomes was insufficient for clinical implementation. Self-assessment tools might be convenient for conducting further studies. A multidisciplinary approach is essential to develop effective intervention protocols. Further research is required to determine these correlations in primary care settings.
已经开发出了各种衡量患者复杂性的工具。初级保健医生经常处理患者的复杂性。然而，它们在初级保健环境中的实用性尚不清楚。本研究探讨了一般成年患者和患者群体中的复杂性衡量工具，以调查患者复杂性与结果之间的相关性，包括与健康相关的患者结果、医疗保健成本以及对医疗保健提供者的影响。我们使用了一个五阶段的范围综述框架，在 MEDLINE 和 CINAHL 中进行了搜索，并包括了已确定研究的参考文献列表。共发现 21 种患者复杂性管理工具。25 项研究考察了患者复杂性与与健康相关的患者结果之间的相关性，两项研究考察了医疗保健成本，一项研究评估了对医疗保健提供者的影响。没有研究在衡量复杂患者的结果时考虑与多学科团队共享信息或行动计划。在这些工具中，有 11 个使用了面对面访谈，7 个从病历中提取数据，3 个使用了自我评估。患者复杂性和结果之间相关性的证据尚不足以为临床实施提供依据。自我评估工具可能更便于进行进一步的研究。多学科方法对于制定有效的干预措施至关重要。需要进一步研究来确定这些相关性在初级保健环境中的情况。
