Wieczorek-Wójcik Beata, Milewska Anna Justyna, Kilańska Dorota, Kulma-Pytlak Aneta, Iltchev Peter, Gaworska-Krzemińska Aleksandra, Kozlowski Remigiusz
Department of Nursing and Medical Rescue, Pomeranian University in Slupsk, Westerplatte Street 64, 76-200 Słupsk, Poland.
Department of Biostatistics and Medical Informatics, Medical University of Białystok, 15-295 Białystok, Poland.
Healthcare (Basel). 2025 Apr 29;13(9):1026. doi: 10.3390/healthcare13091026.
Integrated health services are health services that are managed and delivered in a way that ensures patients receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation, and palliative care services at different levels and sites of care within the health system, and according to their needs, throughout their life course. Assessing the effectiveness of their implementation, the perspective of the process participant-the patient-is examined. There are three main types of patient-reported measures: PROM, PREM and HLS. PREM (patient-reported experience measure) is a tool that allows the objective measurement of the patient's experience related to healthcare services, for instance, the timeliness of visits or receiving recommendations. The aim of this study was to evaluate the coordinated care experienced by patients (PREMs) before and after the introduction of coordinated care, using the JOP-POP tool as a key measure. This longitudinal study was conducted in two stages. The first stage concerned the joining of the coordinated care program by the entity in which the study was conducted; the study was repeated six months after joining coordinated care (CC). At each stage of the study, the study group included 40 patients. The Shapiro-Wilk test was used to verify the normality of the distribution of quantitative variables. For statistical analysis, the Wilcoxon test for paired samples was used to compare two ordinal dependent variables. For independent variables, the Mann-Whitney and the Kruskal-Wallis ANOVA by ranks tests were used, with a post hoc test of multiple comparisons of mean ranks. A statistically significant relationship ( = 0.00157) was observed between the number of chronic diseases and health status assessment before inclusion in coordinated care. The patients' responses showed statistically significant improvement 6 months after the introduction of coordinated care (CC). The improvement in assessment was related to the time physicians spent with patients. The greatest improvement over 6 months was achieved in coordination of care and the smallest improvement was noted in the approach to the patient. The JOP-POP tool may be useful in future studies to assess patients' experiences with implementing coordinated care.
综合健康服务是指以一种确保患者在卫生系统内不同层次和地点的医疗服务中，根据自身需求在整个生命历程中获得连续的健康促进、疾病预防、诊断、治疗、疾病管理、康复和姑息治疗服务的方式进行管理和提供的健康服务。在评估其实施效果时，会考察过程参与者——患者的视角。患者报告的测量主要有三种类型：患者报告结局（PROM）、患者报告体验测量（PREM）和健康素养量表（HLS）。患者报告体验测量（PREM）是一种工具，可客观测量患者与医疗服务相关的体验，例如就诊的及时性或接受建议的情况。本研究的目的是使用JOP - POP工具作为关键指标，评估引入协调护理前后患者所体验到的协调护理（PREM）情况。这项纵向研究分两个阶段进行。第一阶段涉及开展研究的实体加入协调护理项目；在加入协调护理（CC）六个月后重复该研究。在研究的每个阶段，研究组包括40名患者。使用夏皮罗 - 威尔克检验来验证定量变量分布的正态性。对于统计分析，使用配对样本的威尔科克森检验来比较两个有序因变量。对于自变量，使用曼 - 惠特尼检验和秩和检验的克鲁斯卡尔 - 沃利斯方差分析，并进行平均秩的多重比较的事后检验。在纳入协调护理之前，观察到慢性病数量与健康状况评估之间存在统计学显著关系（= 0.00157）。引入协调护理（CC）六个月后，患者的反应显示出统计学上的显著改善。评估的改善与医生与患者相处的时间有关。在六个月内，护理协调方面取得的改善最大，而在对待患者的方式方面改善最小。JOP - POP工具在未来评估患者实施协调护理体验的研究中可能会有用。
