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确定伊朗初级卫生保健转诊系统老年评估的最小数据集:将老年人的护理从碎片化转变为整合化。

Determining the minimum data set of geriatric assessment at the Iran primary health care referral system: shifting from fragmentation to integration care for older people.

机构信息

Department of Health Information Management, Shahrekord University of Medical Sciences, Shahrekord, Iran.

Department of Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.

出版信息

BMC Health Serv Res. 2024 Sep 7;24(1):1039. doi: 10.1186/s12913-024-11498-8.

DOI:10.1186/s12913-024-11498-8
PMID:39244560
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11380327/
Abstract

BACKGROUND

Geriatric assessment (GA) is a multidimensional process that disrupts the primary health care (PHC) referral system. Accessing consistent data is central to the provision of integrated geriatric care across multiple healthcare settings. However, due to poor-quality data and documentation of GA, developing an agreed minimum data set (MDS) is required. Therefore, this study aimed to develop a GA-MDS in the PHC referral system to improve data quality, data exchange, and continuum of care to address the multifaceted necessities of older people.

METHODS

In our study, the items to be included within GA-MDS were determined in a three-stepwise process. First, an exploratory literature search was done to determine the related items. Then, we used a two-round Delphi survey to obtain an agreement view on items to be contained within GA-MDS. Finally, the validity of the GA-MDS content was evaluated.

RESULTS

Sixty specialists from different health geriatric care disciplines scored data items. After, the Delphi phase from the 230 selected items, 35 items were removed by calculating the content validity index (CVI), content validity ratio (CVR), and other statistical measures. Finally, GA-MDS was prepared with 195 items and four sections including administrative data, clinical, physiological, and psychological assessments.

CONCLUSIONS

The development of GA-MDS can serve as a platform to inform the geriatric referral system, standardize the GA process, and streamline their referral to specialized levels of care. We hope GA-MDS supports clinicians, researchers, and policymakers by providing aggregated data to inform medical practice and enhance patient-centered outcomes.

摘要

背景

老年评估(GA)是一个多维的过程,会打乱初级卫生保健(PHC)的转诊系统。获取一致的数据是在多个医疗保健环境中提供综合老年护理的核心。然而,由于 GA 的数据和文档质量较差,需要制定一个商定的最小数据集(MDS)。因此,本研究旨在 PHC 转诊系统中制定 GA-MDS,以提高数据质量、数据交换和护理连续性,以满足老年人多方面的需求。

方法

在我们的研究中,GA-MDS 中包含的项目是通过三步过程确定的。首先,进行了探索性文献检索,以确定相关项目。然后,我们使用两轮 Delphi 调查,就包含在 GA-MDS 中的项目达成一致意见。最后,评估了 GA-MDS 内容的有效性。

结果

来自不同健康老年护理学科的 60 名专家对数据项目进行了评分。在 Delphi 阶段,从 230 个选定项目中,通过计算内容有效性指数(CVI)、内容有效性比(CVR)和其他统计措施,删除了 35 个项目。最后,GA-MDS 准备了 195 个项目和四个部分,包括行政数据、临床、生理和心理评估。

结论

GA-MDS 的开发可以作为告知老年转诊系统、规范 GA 流程和简化向专业护理水平转诊的平台。我们希望 GA-MDS 通过提供汇总数据为临床医生、研究人员和政策制定者提供信息,以改善医疗实践并增强以患者为中心的结果。