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利用初级保健学术合作组织探究英国居家老年患者的特征及医疗保健利用情况:一项回顾性观察研究和临床医生调查的方案(CHiP研究)

Using the Primary care Academic CollaboraTive to explore the characteristics and healthcare use of older housebound patients in England: protocol for a retrospective observational study and clinician survey (the CHiP study).

作者信息

Winn Elizabeth, Kissane Madeleine, Merriel Samuel Wd, Brain Thomas, Silverwood Victoria A, Whitehead Ishbel Orla, Howe Laura D, Payne Rupert A, Duncan Polly

机构信息

Centre for Academic Primary Care and Population Health Sciences, University of Bristol, Bristol, UK.

Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK.

出版信息

BJGP Open. 2023 Dec 19;7(4). doi: 10.3399/BJGPO.2023.0114. Print 2023 Dec.

Abstract

BACKGROUND

Older housebound people are an under-researched group for whom achieving good primary health care can be resource intensive.

AIMS

To describe the characteristics and healthcare use of older (≥65 years) housebound people; explore clinician views on delivery of care to housebound people; and assess the feasibility of using a new network of healthcare professionals to deliver high quality research.

DESIGN & SETTING: Retrospective observational study of electronic GP records and clinician survey in England.

METHOD

Clinical members of a new UK research network called the Primary care Academic CollaboraTive (PACT) will collect the data. For part A, around 20 GP practices will be recruited and clinicians will identify 20 housebound and 20 non-housebound people, matched by age and gender (around 400 total in each group). Anonymised data will be collected on characteristics (age, gender, ethnicity, deprivation decile), long-term conditions, prescribed medicines, quality of healthcare (via Quality Outcomes Framework targets), and continuity of care. Reports with benchmarked practice-level data will be provided to practices to identify areas for quality improvement and to enhance engagement. For part B, 2-4 clinicians will be recruited from around 50 practices in England (around 150 clinicians) to complete a survey about delivery of healthcare for housebound people. For part C, data will be collected to assess the feasibility of using the PACT network to deliver primary care research.

CONCLUSION

Older housebound people are a neglected group both in terms of research and clinical care. Understanding the characteristics and use of primary healthcare of housebound people will help identify how to improve their care.

摘要

背景

居家养老的老年人是一个研究不足的群体,为他们提供良好的初级医疗保健可能需要大量资源。

目的

描述居家养老的老年人(≥65岁)的特征和医疗保健使用情况;探讨临床医生对为居家养老者提供护理的看法;评估利用新的医疗专业人员网络开展高质量研究的可行性。

设计与设置

对英格兰电子全科医生记录进行回顾性观察研究并开展临床医生调查。

方法

一个名为初级保健学术协作组织(PACT)的英国新研究网络的临床成员将收集数据。对于A部分,将招募约20家全科医生诊所,临床医生将识别出20名居家养老者和20名非居家养老者,按年龄和性别进行匹配(每组总计约400人)。将收集关于特征(年龄、性别、种族、贫困十分位数)、长期疾病、处方药、医疗保健质量(通过质量结果框架指标)以及护理连续性的匿名数据。将向诊所提供具有基准实践水平数据的报告,以确定质量改进领域并加强参与度。对于B部分,将从英格兰约50家诊所(约150名临床医生)中招募2 - 4名临床医生,以完成一项关于为居家养老者提供医疗保健的调查。对于C部分,将收集数据以评估利用PACT网络开展初级保健研究的可行性。

结论

无论是在研究还是临床护理方面,居家养老的老年人都是一个被忽视的群体。了解居家养老者的特征和初级医疗保健使用情况将有助于确定如何改善他们的护理。

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