Boudreaux M C, Miller J M, Wightkin J, Martin S, Mather F
Department of Obstetrics and Gynecology, LSU Medical Center, New Orleans 70112, USA.
J Perinatol. 1997 Jan-Feb;17(1):33-6.
In this article we describe a program that evolved from collaborative care given to a low-risk population into collaborative care that included patients at high risk.
The study population comprised women attending a prenatal program in an urban, underserved neighborhood. Clinic records were reviewed for number of patient enrollments and total patient visits, as well as providers utilized. Episodic audit over a 3-year period of 180 of 869 patients initiating prenatal care was done. Data from vital statistics for 1992 and 1993 were evaluated for adequacy of prenatal care and yearly births for the census tract served. Analysis was descriptive.
Almost all of the patient population served was found to be at psychosocial high risk. Approximately 10% had significant obstetric or medical complications. Infections, especially sexually transmitted diseases, were common. Fewer than 1% of the patients were referred to another provider for treatment. The program demonstrated an increase in patient volume, improved retention of patients for complete prenatal care and delivery, a reduction in patients receiving no or inadequate care, and a reduction in yearly births.
The collaborative practice model may be extended to high-risk populations.
在本文中，我们描述了一个从为低风险人群提供的协作式护理发展而来的项目，该项目后来纳入了高风险患者的协作式护理。
研究人群包括在城市中服务欠缺社区参加产前项目的女性。对诊所记录进行了审查，内容包括患者登记数量、总就诊次数以及所使用的医疗服务提供者。对869名开始接受产前护理的患者中的180名进行了为期3年的定期审核。对1992年和1993年生命统计数据进行了评估，以了解所服务普查区的产前护理充分性和年度出生情况。分析采用描述性方法。
几乎所有所服务的患者人群都被发现处于心理社会高风险状态。约10%的患者有严重的产科或医疗并发症。感染，尤其是性传播疾病很常见。不到1%的患者被转介给其他医疗服务提供者进行治疗。该项目显示患者数量增加，接受完整产前护理和分娩的患者留存率提高，接受无护理或护理不足的患者减少，年度出生数减少。
协作实践模式可扩展至高风险人群。
