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基于 Boruta 的方法分析具有双通道扩散和分层守门人系统的医疗保健分层中的远程医疗融合。

Boruta-driven analysis of telehealth amalgamation across healthcare stratifications with diffuse-dual-channel and tiered-gatekeeper systems.

机构信息

Department of Public Health, University of the Punjab, Lahore, Pakistan.

Pakistan Administrative Service (PAS), Lahore, Pakistan.

出版信息

Sci Rep. 2024 Oct 21;14(1):24784. doi: 10.1038/s41598-024-76295-z.

DOI:10.1038/s41598-024-76295-z
PMID:39433883
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11494082/
Abstract

This study aimed to evaluate the adaptation and effectiveness of telemedicine with the diffuse-dual-channel system (DDS) and tiered-gatekeeper system (TGS) across different tiers of the healthcare system on technical-organizational-environmental (TOE) framework. The telemedicine services were extended as Tiered-gatekeeper system (TGS) by Primary and Secondary Healthcare (PSHC) and Diffuse-dual-channel system (DDS) by King Edward Medical University (KEMU) in 2020 benefiting 2605 and 21,905 patients, respectively. This cross-sectional survey is based on a structured questionnaire conducted on 172 healthcare practitioners (HCP) from KEMU and 76 from PSHC selected by purposive sampling and analysis is conducted through descriptive analysis and the Boruta features selection method. The diffuse-dual-channel system is found to be flexible, easy to implement, and impactful due to innate compatibility with prevailing healthcare practices, however, it is a parallel effort to the existing healthcare system. The tiered-gatekeeping system is found to be complex in adaptation initially, but is more organized, deeply integrated, accountable and channelizes the flow of patients, resultantly aiding the preservation of resources.

摘要

本研究旨在评估远程医疗在不同医疗保健系统层级上基于技术-组织-环境（TOE）框架的弥散双通道系统（DDS）和分层守门人系统（TGS）的适应性和有效性。远程医疗服务于 2020 年通过初级和二级保健（PSHC）扩展为分层守门人系统（TGS），通过爱德华国王医学院（KEMU）扩展为弥散双通道系统（DDS），分别受益于 2605 名和 21905 名患者。这项横断面调查是基于对 KEMU 的 172 名医疗保健从业者（HCP）和 PSHC 的 76 名医疗保健从业者（HCP）进行的结构化问卷调查，采用目的抽样选择，并通过描述性分析和 Boruta 特征选择方法进行分析。发现弥散双通道系统由于与现有医疗保健实践的固有兼容性而具有灵活性、易于实施和影响力，但它是对现有医疗保健系统的并行努力。发现分层守门人系统在最初的适应过程中较为复杂，但更具组织性、深度整合性、问责制和患者流程导向性，从而有助于资源的保存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/c3070ae3ecef/41598_2024_76295_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/69a899d5d2ef/41598_2024_76295_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/f01797cec88f/41598_2024_76295_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/fb55ba627dea/41598_2024_76295_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/52d8dfee5c54/41598_2024_76295_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/c3070ae3ecef/41598_2024_76295_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/69a899d5d2ef/41598_2024_76295_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/f01797cec88f/41598_2024_76295_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/fb55ba627dea/41598_2024_76295_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/52d8dfee5c54/41598_2024_76295_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84a4/11494082/c3070ae3ecef/41598_2024_76295_Fig5_HTML.jpg

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