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优化神经外科门诊手术:芬兰公共医疗系统干预措施的比较研究

Optimizing neurosurgery clinic operations: a comparative study of interventions in Finland's public healthcare system.

作者信息

Huttunen Jukka, Koivisto Timo

机构信息

Department of Neurosurgery, Kuopio University Hospital, Puijonlaaksontie 2, Kuopio 70210, Finland.

Institute of Clinical Medicine, University of Eastern Finland, Puijonlaaksontie 2, Kuopio 70210, Finland.

出版信息

Int J Qual Health Care. 2024 Dec 18;36(4). doi: 10.1093/intqhc/mzae106.

Abstract

BACKGROUND

The Finnish public healthcare system aims to ensure equal access to health services for all but faces challenges in meeting the demand for specialized care, such as neurosurgery, due to resource constraints. This study investigates interventions to increase resources at a neurosurgery outpatient clinic to improve patient care without compromising waiting times for diagnoses and treatments, leveraging Finland's unique healthcare landscape.

METHODS

The study was conducted at Kuopio University Hospital's Department of Neurosurgery, the sole provider of neurosurgical care in Eastern Finland. Two interventions were designed to optimize clinic operations: one focusing on dynamic resource allocation through continuous monitoring and the other on establishing a fixed additional neurosurgeon slot. Process capability and regression analysis were employed to evaluate the effects of these interventions on the number of outpatient visits and the variability in daily patient numbers.

RESULTS

The preliminary analysis showed an average of 9.3 outpatient visits per day (SD 5.2). The introduction of an additional neurosurgeon led to an increase of 5.014 visits per day, according to the regression analysis performed before the interventions. Following the interventions, the clinic observed an increase in the average number of daily outpatient visits to 9.8 after the first intervention and 11.6 after the second, with corresponding improvements in the number of neurosurgeons present. The second intervention, which established a predictable additional resource, resulted in a more significant improvement in process efficiency and stability. After the interventions, the number of new neurosurgical first patient visits increased by 7% (97 patients).

CONCLUSION

This study demonstrates the importance of structured and predictable resource allocation in enhancing the efficiency of specialized healthcare services, particularly in neurosurgery. It also underscores the potential of planned interventions to manage and improve patient care in a publicly funded healthcare system, despite the challenges posed by limited resources and the need for prioritization. Moreover, the findings highlight the necessity of ongoing measurement and analysis of development projects to ensure sustained improvement and avoid regression in process quality.

摘要

背景

芬兰公共医疗体系旨在确保全民平等获得医疗服务,但由于资源限制,在满足神经外科等专科护理需求方面面临挑战。本研究利用芬兰独特的医疗格局,调查在神经外科门诊增加资源的干预措施,以改善患者护理,同时不影响诊断和治疗的等待时间。

方法

该研究在库奥皮奥大学医院神经外科进行,该科室是芬兰东部唯一提供神经外科护理的机构。设计了两项干预措施以优化门诊运作:一项通过持续监测专注于动态资源分配,另一项是设立固定的额外神经外科医生岗位。采用过程能力分析和回归分析来评估这些干预措施对门诊就诊次数和每日患者数量变异性的影响。

结果

初步分析显示,每天平均门诊就诊次数为9.3次(标准差5.2)。根据干预前进行的回归分析,增设一名神经外科医生使每天就诊次数增加了5.014次。干预后,门诊观察到第一次干预后每日门诊就诊平均次数增加到9.8次,第二次干预后增加到11.6次,同时在场神经外科医生数量也相应增加。第二项干预措施设立了可预测的额外资源,使过程效率和稳定性有了更显著的改善。干预后,神经外科新患者首次就诊人数增加了7%(97名患者)。

结论

本研究表明,结构化和可预测的资源分配对于提高专科医疗服务效率,尤其是神经外科服务效率至关重要。它还强调了在公共资助的医疗体系中,尽管存在资源有限和需要进行优先排序的挑战,但计划性干预措施在管理和改善患者护理方面的潜力。此外,研究结果凸显了对发展项目进行持续测量和分析的必要性,以确保持续改进并避免过程质量倒退。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9653/11654246/3b637768fded/mzae106f1.jpg

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