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[提高巴伐利亚农村地区远程委托家访的效率:VERSORGT am ORT研究的中期结果]

[Increasing the efficiency of remote delegated home visits in a rural region of Bavaria: interim results of the VERSORGT am ORT study].

作者信息

Hofmann Reiner, Lörzing Romina, Emmert Martin, Bräuer Julia

机构信息

Medizincampus Oberfranken, Klinikum Bayreuth GmbH, Bayreuth, Germany.

Projektgeschäftsstelle Medizincampus Oberfranken, Universität Bayreuth, Bayreuth, Germany.

出版信息

Gesundheitswesen. 2025 Jul 8. doi: 10.1055/a-2620-5842.

Abstract

Against the background of increasing problems in the provision of medival care in rural regions, the further development of outpatient medical concepts focussing on the imperative of economic efficiency and economy is essential. The delegation of medical tasks to medical assistants (MFA) offers a promising approach to relieve the burden on GPs and to support the provision of sustainable care. The 'VERSORGT am ORT' (VaO) project develops this principle and aims to reduce working hours away from patients by partially shifting delegated home visits to specialised care rooms without compromising the quality of care.Parameters for evaluating the VaO concept were quality of life (LQ) and satisfaction (PZ) of patients through standardized questionnaires, time spent away from patients and distance travelled. An initial data analysis from May 2024 to May 2025 compared the standard in the form of home visits (home visit /HB scenario) with partial transfer to VaO rooms according to the VaO model (VaO scenario) using paired t-tests over two survey time points.The n=134 data sets analysed showed significant differences in favour of the VaO model in the scenario comparison. The mean differences for travel time were MW=1.89 [min], travel time MW=2.79 [min], set-up time MW=0.63 [min], total time MW=5.32 [min] and kilometres travelled MW=1.89 [km] with p-values<0.001. Overall, a 20.9% reduction in working time away from the patient from 25.32 to 20.01 min and a 7.8% reduction in kilometres travelled from 13.34 to 12.30 km were achieved. The psychological component of the patients' LQ improved significantly from MW=52.94 to MW=57.27. The physical sum scale increased slightly from MW=41.01 to MW=43.94. Satisfaction remained almost unchanged.These results indicate that the VaO system can significantly increase the efficiency of GP care in rural areas. Despite a small absolute difference in the figures, the relative comparison already shows the potential and the increased efficiency of this innovative form of care. In addition, the interim evaluation shows that the concept does not lead to negative effects on QoL and patient satisfaction. An expansion to other regions and an in-depth analysis of the outcome parameters in further studies are recommended.

摘要

在农村地区提供医疗服务问题日益增多的背景下,进一步发展以经济效率和经济性为要务的门诊医疗理念至关重要。将医疗任务委托给医疗助理(MFA)提供了一种有前景的方法,可减轻全科医生的负担并支持提供可持续的医疗服务。“就地提供护理”(VERSORGT am ORT,VaO)项目发展了这一原则,旨在通过将部分委托的家访转移到专门的护理室来减少远离患者的工作时间,同时不降低护理质量。通过标准化问卷评估VaO概念的参数包括患者的生活质量(LQ)和满意度(PZ)、远离患者的时间以及出行距离。2024年5月至2025年5月的初步数据分析,在两个调查时间点使用配对t检验,将家访形式的标准(家访/HB情景)与根据VaO模型部分转移到VaO房间的情况(VaO情景)进行比较。分析的n = 134个数据集显示,在情景比较中,结果显著有利于VaO模型。出行时间的平均差异为MW = 1.89[分钟],路途时间MW = 2.79[分钟],准备时间MW = 0.63[分钟],总时间MW = 5.32[分钟],出行公里数MW = 1.89[公里],p值<0.001。总体而言,远离患者的工作时间从25.32分钟减少到20.01分钟,减少了20.9%,出行公里数从13.34公里减少到12.30公里,减少了7.8%。患者LQ的心理成分从MW = 52.94显著提高到MW = 57.27。身体总分量表从MW = 41.01略有增加到MW = 43.94。满意度几乎保持不变。这些结果表明,VaO系统可显著提高农村地区全科医生护理的效率。尽管数据中的绝对差异较小,但相对比较已经显示出这种创新护理形式的潜力和更高的效率。此外,中期评估表明,该理念不会对生活质量和患者满意度产生负面影响。建议在其他地区推广,并在进一步研究中对结果参数进行深入分析。

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