School of Sport, Exercise and Rehabilitation Science, Faculty of Health Sciences, University of Hull, Hull, United Kingdom.
The Health and Wellbeing Service - Primary Care, City Health Care Partnership CIC, Marfleet Lane Surgery, Hull, United Kingdom.
PLoS One. 2024 Apr 5;19(4):e0298955. doi: 10.1371/journal.pone.0298955. eCollection 2024.
A health and lifestyle advisor service embedded within primary care was piloted in Kingston-upon-Hull from January 2021. We aimed to evaluate the first two years of service delivery by identifying patient demographics referred to the service, reason for referral, determine uptake and retention rates, and monitor individual lifestyle-related risk factor changes following discharge.
Anonymised data were extracted from the SystmOne database for all patients referred to the service between January 2021 and January 2023.
In the initial two years of the service, 705 unique patients were referred at a mean rate of ∼29 per month. Each unique patient received a median (robust median absolute deviation; [MAD]) of 3 (Steel N, et al 2018) planned consultations prior to discharge over this period. The majority of referrals were for symptom management and health promotion purposes (95%). Of those referred, 69% attended their appointments, and 14% did not attend. The majority of referrals were white British (55%), however, the service did receive a substantial number of referrals from minority ethnic groups, with only 67% of referrals speaking English as their main language. Eighteen distinct languages were spoken. Most referrals were classified as class I obese (59.4%). Across initial and final appointments, median (robust MAD) systolic blood pressure was 130 (15) mmHg and 130 (15) mmHg, and median (robust MAD) waist circumference was 103.0 (13.3) cm and 101.0 (13.3) cm.
The evaluation highlighted the demand for this service embedded within primary care settings in Kingston-upon-Hull. Service engagement was evident, and a large proportion of those who engaged were from minority ethnic groups. A high proportion of referrals presented with obesity and/or hypertension which requires further investigation.
2021 年 1 月起，金斯顿赫尔（Kingston-upon-Hull）在基础医疗中嵌入健康和生活方式顾问服务进行试点。我们旨在通过确定服务对象的患者人口统计学信息、转诊原因、评估参与率和保留率，并监测每位患者在离院后的生活方式相关风险因素变化，来评估头两年的服务交付情况。
从 2021 年 1 月至 2023 年 1 月间，所有被转诊到该服务的患者的匿名数据均从 SystmOne 数据库中提取。
在服务开展的头两年，平均每月约有 29 名患者被转诊，共涉及 705 名独特患者。在此期间，每位患者在离院前都接受了中位数（稳健中位数绝对偏差[MAD]）为 3 次（Steel N，等，2018）的计划咨询。转诊的主要目的是为了进行症状管理和健康促进（95%）。在转诊的患者中，69%的人接受了预约，14%的人未接受预约。转诊患者中，白人英国人占 55%，但该服务确实收到了相当数量的少数族裔患者的转诊，其中只有 67%的患者以英语作为主要语言。有 18 种不同的语言。大多数患者被归类为一级肥胖（59.4%）。在初次和最终就诊时，收缩压的中位数（稳健 MAD）为 130（15）mmHg 和 130（15）mmHg，腰围中位数（稳健 MAD）为 103.0（13.3）cm 和 101.0（13.3）cm。
评估结果突显了在金斯顿赫尔的基础医疗环境中对这种服务的需求。服务参与度高，其中很大一部分参与者来自少数族裔。大量转诊患者存在肥胖和/或高血压问题，需要进一步调查。
