对悉尼西部一家创新型初级和中级糖尿病诊所的定性和定量评估

IF 2.6 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES International Journal of Integrated Care Pub Date : 2024-02-21 DOI:10.5334/ijic.7548
Sumathy Ravi, G. Meyerowitz-katz, Anandhi Murugesan, J. Ayre, R. Jayaballa, Duncan Rintoul, Marina Sarkis, Kirsten J McCaffery, G. Maberly, C. Bonner
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摘要

导言:西悉尼糖尿病中心(WSD)于 2020 年 5 月建立了一项创新型糖尿病服务,采用虚拟和面对面护理的方式,将初级保健与糖尿病专家团队联系起来。本研究采用定性和定量方法对该服务的可行性进行了评估。方法:评估包括1)对患者和医疗专业人员的访谈和研讨会进行主题分析(n = 28);2)对 2020 年 7 月至 2021 年 6 月入院患者的记录进行定量分析(n = 110)。结果:关键主题涉及:1)益处:地点便利、可获得综合护理、虚拟护理的优势;2)挑战:患者难以提问、技术问题;3)信心:共同护理决策、多学科团队;以及 4)未来方向:额外的多学科服务、扩大胰岛素稳定服务、推广。基线与 3 个月之间的改善包括 HbA1c 降低 1.3%(p < 0.05)。磺脲类药物在首次预约和随访期间减少了 25%,GLP1RA/SGLT2i 的使用增加了 30%(p < 0.05)。诊所使用医疗保险账单和全国加权活动单位支付费用。讨论:研究结果表明,这种综合护理模式是可行的,患者和医疗服务提供者都认为这种模式有益。该诊所提供了一种很有前景的实践模式,可以进一步发展,在其他地区的农村地区推广。
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Qualitative and Quantitative Evaluation of an Innovative Primary and Secondary Diabetes Clinic in Western Sydney
Introduction: Western Sydney Diabetes (WSD) established an innovative diabetes service in May 2020, using virtual and in-person care, linking primary care with the diabetes specialist team. This study evaluated the service’s feasibility using qualitative and quantitative methods. Method: Evaluation included: 1) thematic analysis of interviews and workshops with patients and health professionals (n = 28); 2) quantitative analysis of records of patients admitted July 2020–June 2021 (n = 110). Results: Key themes related to 1) benefits: convenient location, access to integrated care, advantages of virtual care; 2) challenges: hard for patients to ask questions, technology issues; 3) confidence: shared care decision making, multidisciplinary team; and 4) future directions: additional multidisciplinary services, expanded insulin stabilisation service, promotion. Improvements between baseline and 3 months included 1.3% reduction in HbA1c (p < 0.05). Sulfonylurea dropped by 25% between initial appointment and follow-up, and GLP1RA/SGLT2i use increasing by 30% (p < 0.05). The clinic covered costs using Medicare billings and Nationally Weighted Activity Units. Discussion: The findings suggest this integrated care model was feasible and perceived as beneficial by both patients and providers. The clinic offers a promising model of practice that could be developed further to roll out in other regions for rural delivery of care.
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来源期刊
International Journal of Integrated Care
International Journal of Integrated Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.80
自引率
8.30%
发文量
887
审稿时长
>12 weeks
期刊介绍: Established in 2000, IJIC’s mission is to promote integrated care as a scientific discipline. IJIC’s primary purpose is to examine critically the policy and practice of integrated care and whether and how this has impacted on quality-of-care, user experiences, and cost-effectiveness. The journal regularly publishes conference supplements and special themed editions. To find out more contact Managing Editor, Susan Royer. The Journal is supported by the International Foundation for Integrated Care (IFIC).
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