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安大略省耳鼻喉科医生对基于社区的医疗保健中管理等待时间的单次就诊模式的看法:一项定性研究。

Perceptions of Otolaryngologists on Single-Entry Models for Managing Wait Times in Community-Based Health Care in Ontario: A Qualitative Study.

作者信息

Shapiro Justin, Perlmutter Jonah, Axelrod Charlotte, Bandargal Saruchi, Pundaky Gabie, Levy Ben B, Grad Veronica, Almeida John de, Davies Joel, Rotenberg Brian, Eskander Antoine, Chung Janet, Urbach David R, Chan Yvonne

机构信息

Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.

Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

出版信息

J Otolaryngol Head Neck Surg. 2025 Jan-Dec;54:19160216251336682. doi: 10.1177/19160216251336682. Epub 2025 May 15.

Abstract

ImportanceLong wait times for medical care have been exacerbated following the pandemic in many health systems. Single-entry models (SEMs) have been proposed as a strategy to manage growing surgical backlogs and increase timeliness and quality of care by creating a single queue and centralizing the referral triage process.ObjectiveThe primary objective was to evaluate the perceptions of SEMs among community otolaryngologists for managing surgical backlogs. The secondary objectives were to better understand their experiences with the current system and to investigate their recommendations for implementing an SEM.DesignInterpretive Description.SettingOntario, Canada.ParticipantsNine community-based otolaryngologists.Intervention/ExposuresNot available.MethodsVirtual semi-structured interviews were conducted with study participants. Data were independently analyzed using inductive and deductive methods by multiple team members. Results were triangulated, and a final coding framework was developed collaboratively from which themes were identified.Main Outcome MeasuresPerceptions of SEMs as well as recommendations for design and implementation.ResultsThree thematic domains and 9 subdomains were identified from our interview data: (1) factors affecting the utility of SEMs; (2) opinions and buy-in of physicians; and (3) opportunities to improve equity.Conclusions and RelevanceWe identified a number of factors that should be considered in supporting community-based otolaryngologists to adopt SEMs as a strategy for ensuring timely and equitable access to care. Clinical leaders and specialty organizations play a pivotal role for such changes to succeed. Implementing SEMs may be an important step toward increasing equity, quality, efficiency, and cost-effectiveness in otolaryngology.

摘要

重要性

在许多医疗系统中,疫情之后医疗护理的长时间等待问题更加严重。单入口模式(SEMs)已被提议作为一种策略,通过创建单一队列和集中转诊分诊流程来管理日益增加的手术积压,并提高护理的及时性和质量。

目的

主要目的是评估社区耳鼻喉科医生对单入口模式在管理手术积压方面的看法。次要目的是更好地了解他们在当前系统中的经历,并调查他们对实施单入口模式的建议。

设计

诠释性描述。

背景

加拿大安大略省。

参与者

九位社区耳鼻喉科医生。

干预/暴露

无。

方法

对研究参与者进行虚拟半结构化访谈。数据由多名团队成员使用归纳和演绎方法独立分析。结果进行三角验证,并共同制定最终编码框架,从中确定主题。

主要观察指标

对单入口模式的看法以及设计和实施建议。

结果

从我们的访谈数据中确定了三个主题领域和九个子领域

(1)影响单入口模式效用的因素;(2)医生的意见和支持;(3)改善公平性的机会。

结论及相关性

我们确定了一些在支持社区耳鼻喉科医生采用单入口模式作为确保及时和公平获得护理的策略时应考虑的因素。临床领导者和专业组织对于此类变革的成功起着关键作用。实施单入口模式可能是朝着提高耳鼻喉科的公平性、质量、效率和成本效益迈出的重要一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9907/12081981/9e58aca596de/10.1177_19160216251336682-img2.jpg

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