初级保健创新基金医疗模式的经验:德国全科医生的定性研究

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL Wiener medizinische Wochenschrift Pub Date : 2024-03-01 Epub Date: 2022-05-03 DOI:10.1007/s10354-022-00935-0
Julian Wangler, Michael Jansky
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引用次数: 0

摘要

创新基金成立于 2015 年,旨在改善德国法定医疗保险体系中的医疗服务。基层医疗机构需要参与测试干预措施和新的医疗形式的有效性,并将其纳入标准医疗中。迄今为止,几乎没有任何关于创新基金模式在多大程度上适应基层医疗机构的研究,也没有任何关于全科医生使用这些模式的经验的研究。2021 年 9 月至 2022 年 1 月期间,我们对已参与创新基金项目的全科医生进行了 36 次半标准化的个别访谈。莱茵兰-法尔茨、黑森、北莱茵-威斯特伐利亚和石勒苏益格-荷尔斯泰因的 11 个地区医生网络参与了招募过程。大多数受访者认为创新基金具有潜力和机遇,包括加强以应用为导向的医疗保健研究、独立融资和普通医疗保健参与。尽管如此,许多全科医生并不确定创新基金在多大程度上能使基层医疗机构长期受益。在参与护理模式--干预的效益以及成本效益比方面,大多取得了积极的平衡。然而,一些人也报告了一些障碍和压力因素,如文件要求和对日常办公室工作的干扰。创新基金项目需要适合全科医生,特别是在医疗决策余地、文件要求限制、保留办公室常规、更多参与研究规划以及改善初级保健环境等方面,以鼓励全科医生参与创新基金项目的意愿。
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Experiences with Innovation Fund healthcare models in primary care: a qualitative study amongst German general practitioners.

The Innovation Fund was set up in 2015 with the aim of improving medical care in the German statutory health insurance system. Primary care needs to be involved in testing interventions and new forms of care for effectiveness and inclusion in standard care. There has so far been hardly any research on how far Innovation Fund models accommodate the primary care setting, or on the experience general practitioners have had with these models. Between September 2021 and January 2022, 36 semi-standardized individual interviews were performed with general practitioners who had already participated in Innovation Fund projects. Eleven regional physician networks in Rhineland-Palatinate, Hesse, North Rhine-Westphalia, and Schleswig-Holstein were involved in the recruitment process. Most of the interviewees associated the Innovation Fund with potential and opportunity including intensification of application-oriented healthcare research, independent financing, and general healthcare involvement. Even so, many general practitioners were unsure as to how far primary care in particular would stand to benefit from the Innovation Fund in the long term. A mostly positive balance was drawn from participation in care models-benefit of intervention as well as cost-benefit ratio. However, some also reported hurdles and stress factors such as documentation requirements and disruption in everyday office routine. Innovation Fund projects will need to be suitable for general practitioners especially regarding medical decision-making leeway, limits to documentation requirements, preserving established office routine, greater involvement in research planning, and improvements to the primary care setting to encourage willingness to participate in Innovation Fund projects amongst general practitioners.

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来源期刊
Wiener medizinische Wochenschrift
Wiener medizinische Wochenschrift MEDICINE, GENERAL & INTERNAL-
CiteScore
2.50
自引率
0.00%
发文量
79
期刊介绍: ''From the microscope to clinical application!'', Scientists from all European countries make available their recent research results and practical experience through Wiener Medizinische Wochenschrift, the renowned English- and German-language forum. Both original articles and reviews on a broad spectrum of clinical and preclinical medicine are presented within the successful framework of thematic issues compiled by guest editors. Selected cutting-edge topics, such as dementia, geriatric oncology, Helicobacter pylori and phytomedicine make the journal a mandatory source of information.
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