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三种在庇护所住房中组织全科医生医疗服务的方式。一项定性研究。

Three ways of organising general practitioner's medical services in sheltered housing. A qualitative study.

机构信息

Centre for Care Research East, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

出版信息

Scand J Prim Health Care. 2023 Dec;41(4):400-410. doi: 10.1080/02813432.2023.2256381. Epub 2023 Sep 14.

Abstract

OBJECTIVE

Explore care providers' experiences with the organisation of the medical services for residents in round-the-clock staffed sheltered housing.

DESIGN

Qualitative study and thematic analysis of individual interviews after strategic sampling of participants.

SETTING

Round-the-clock staffed sheltered housing in seven municipalities, inhabited by various user groups, and GPs in various locations in Norway.

SUBJECTS

In-depth interviews with 18 participants: 11 managers or employees in sheltered housing and seven GPs.

MAIN OUTCOME MEASURES

Main themes and subthemes reporting participants' experiences of medical provision to sheltered housing residents.

RESULTS

Three main models of organizing medical services for round-the-clock staffed sheltered housing were identified: (i) the 'multiple GP' model, where each resident has their own individual GP; (ii) the 'single GP' model, where all residents in the sheltered housing have one common GP; (iii) the 'hybrid' model, where a few dedicated GPs follow up the residents.

CONCLUSION

Residents in round-the-clock staffed sheltered housing constitute a varied group that generally has substantial medical assistance needs. Given that many residents lack autonomy to manage their own care needs and make decisions, models with fewer GPs like models ii and iii seem to provide a better medical professional offer. Moving towards such an organising of the medical services for sheltered housing residents could have implications for GPs' workload and competence needs. Future studies are needed to test models and assess implications.

摘要

目的

探讨医护人员在提供 24 小时驻场护理型住房居民医疗服务方面的经验。

设计

对经过战略抽样的参与者进行个人访谈的定性研究和主题分析。

地点

挪威七个市的 24 小时驻场护理型住房,居住着各种不同的用户群体,以及各地的全科医生。

参与者

18 名参与者的深入访谈:11 名护理型住房的经理或员工和 7 名全科医生。

主要结果测量

报告参与者为护理型住房居民提供医疗服务经验的主要主题和子主题。

结果

确定了三种组织 24 小时驻场护理型住房医疗服务的主要模式:(i)“多位全科医生”模式,每位居民都有自己的私人全科医生;(ii)“单一全科医生”模式,所有护理型住房的居民都有一位共同的全科医生;(iii)“混合”模式,少数专门的全科医生为居民提供服务。

结论

24 小时驻场护理型住房的居民构成了一个多样化的群体,他们通常有大量的医疗援助需求。鉴于许多居民缺乏自主管理自己的护理需求和做出决策的能力,像模式 ii 和 iii 这样的医生数量较少的模式似乎提供了更好的医疗专业服务。将这种模式应用于护理型住房居民的医疗服务组织可能会对全科医生的工作量和能力需求产生影响。需要进一步的研究来测试这些模式并评估其影响。

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