German Foundation for the Chronically Ill, Berlin, Germany.
Integrated Care Academy, University of Suffolk, Ipswich, UK.
Eur J Public Health. 2023 Jun 1;33(3):448-454. doi: 10.1093/eurpub/ckad059.
In Europe, more than 15 million people live with heart failure (HF). It imposes an enormous social, organizational and economic burden. As a reaction to impending impact on healthcare provision, different country-specific structures for HF-care have been established. The aim of this report is to provide an overview and compare the HF-care approaches of Germany, Ireland, the Netherlands and the UK, and to open the possibility of learning from each other's experience.
A mixed methods approach was implemented that included a literature analysis, interviews and questionnaires with HF-patients and caregivers, and expert interviews with representatives from healthcare, health service research and medical informatics.
The models of HF-care in all countries analyzed are based on the European Society of Cardiology guidelines for diagnosis and treatment of HF. Even though the HF-models differed in design and implementation in practice, key challenges were similar: (i) unequal distribution of care between urban and rural areas, (ii) long waiting times, (iii) unequal access to and provision of healthcare services, (iv) information and communication gaps and (v) inadequate implementation and financing of digital applications.
Although promising approaches exist to structure and improve HF-care, across the four countries, implementation was reluctant to embrace novel methods. A lack of financial resources and insufficient digitalization making it difficult to adopt new concepts. Integration of HF-nurses seems to be an effective way of improving current models of HF-care. Digital solutions offer further opportunities to overcome communication and coordination gaps and to strengthen self-management skills.
在欧洲，有超过 1500 万人患有心力衰竭（HF）。这给社会、组织和经济带来了巨大的负担。作为对即将对医疗保健供应产生影响的反应，不同国家制定了特定的心力衰竭护理结构。本报告的目的是提供一个概述，并比较德国、爱尔兰、荷兰和英国的心力衰竭护理方法，并为相互学习经验开辟可能性。
采用混合方法，包括对心力衰竭患者和护理人员的文献分析、访谈和问卷调查，以及对医疗保健、卫生服务研究和医学信息学代表的专家访谈。
分析的所有国家的心力衰竭护理模式均基于欧洲心脏病学会关于心力衰竭诊断和治疗的指南。尽管心力衰竭模型在设计和实际实施上有所不同，但关键挑战是相似的：（i）城乡之间的护理分布不均，（ii）等待时间长，（iii）医疗保健服务的获取和提供不平等，（iv）信息和沟通差距，以及（v）数字应用的实施和融资不足。
尽管有一些有前途的方法可以用于构建和改善心力衰竭护理，但在这四个国家中，实施过程对新方法犹豫不决。缺乏资金和数字化程度不足，使得难以采用新的概念。心力衰竭护士的整合似乎是改善当前心力衰竭护理模式的有效途径。数字解决方案提供了进一步的机会，可以克服沟通和协调差距，并加强自我管理技能。
