目的系统梳理新一轮医药卫生体制改革以来农村基本医疗卫生服务综合评价指标体系,基于PHCPI概念框架(primary health care performance initiative conceptual framework)探寻目前评价指标普遍关注的内容和可能被忽略的评价内容,为后续...目的系统梳理新一轮医药卫生体制改革以来农村基本医疗卫生服务综合评价指标体系,基于PHCPI概念框架(primary health care performance initiative conceptual framework)探寻目前评价指标普遍关注的内容和可能被忽略的评价内容,为后续科学、全面地评价农村基本医疗卫生服务提供参考依据。方法通过中国知网、万方数据知识服务平台、维普中文科技期刊数据库检索2009—2019年有关农村基本医疗卫生服务综合评价指标体系的文献,基于SPIDER规范制定纳入排除标准,采用批判评估技术方案对纳入文献进行质量评价,运用框架合成法,选取PHCPI概念框架对纳入的文献进行归纳和总结。结果共纳入25篇文献,总体质量良好。评价体系中的指标可分为5个一级领域、16个二级领域、24个三级领域指标。综合对比各领域对应指标的文献数,卫生资金、效率等领域对应指标的文献数较多,均有20篇左右的文献,高于其他多数领域;投入、产出和结果的相应领域中,近85%的领域对应指标的文献在15篇及以上;服务提供的各领域中,仅18%左右的领域对应指标的文献达到15篇,40%以上领域对应指标的文献未超过5篇。结论农村基本医疗卫生服务综合评价体系对经济效益相关指标关注度较高,投入、产出和结果多数领域的指标重合度较高,评价体系对服务提供领域的关注度较低且内容分散。今后可加强对社会效益和服务提供相关指标的探索,以全面、综合地评价农村基本医疗卫生服务。展开更多
Background:The Primary Eyecare Acute Referral Service(PEARS)and the Wales Eye Health Examination(WEHE)operate as enhanced optometry services for patients residing in Wales,enabling the examination of a patient present...Background:The Primary Eyecare Acute Referral Service(PEARS)and the Wales Eye Health Examination(WEHE)operate as enhanced optometry services for patients residing in Wales,enabling the examination of a patient presenting with an acute eye problem(PEARS)or the examination of patients at higher risk of eye disease(WEHE).The purpose of the study is to assess the demographics of patients accessing these services,referral patterns and clinical management in one Health Board in Wales(Aneurin Bevan University Health Board).Methods:Information from 2302 patients accessing the services was prospectively collected.The following information was obtained:type of examination(PEARS or WEHE),patient age,gender,self-referral or general practitioner(GP)referral and clinical management(no further action,monitor by optometrist or ophthalmic medical practitioner[OMP],refer to the Hospital Eye Service[HES],or refer to GP).Results:There were 1791(77.8%)PEARS examinations and 511(22.2%)WEHE.There were 1379(59.9%)females with a mean age of 58.61(±19.75)and 923(40.1%)males with a mean age of 56.11(±20.42).The majority of patients were self-referrals compared to GP-referrals(1793[77.9%]versus 509[22.1%]respectively).Sub-analysis indicated similar numbers of self-referrals compared to GP-referrals for the WEHE only(297[58.1%]versus 214[41.9%]respectively)but greater numbers of self-referrals for the PEARS examinations only(1496[83.5%]versus 295[16.5%]respectively).For management,75%of patients were monitored by their optometrist or OMP,17%required referral to the HES and 8%required referral to their GP.Conclusions:Higher numbers of females accessed both PEARS and WEHE services and the majority of patients self-referred.These findings have important implications for public health campaigns both for targeting specific groups(e.g.male patients)and increasing awareness among GPs.展开更多
文摘目的系统梳理新一轮医药卫生体制改革以来农村基本医疗卫生服务综合评价指标体系,基于PHCPI概念框架(primary health care performance initiative conceptual framework)探寻目前评价指标普遍关注的内容和可能被忽略的评价内容,为后续科学、全面地评价农村基本医疗卫生服务提供参考依据。方法通过中国知网、万方数据知识服务平台、维普中文科技期刊数据库检索2009—2019年有关农村基本医疗卫生服务综合评价指标体系的文献,基于SPIDER规范制定纳入排除标准,采用批判评估技术方案对纳入文献进行质量评价,运用框架合成法,选取PHCPI概念框架对纳入的文献进行归纳和总结。结果共纳入25篇文献,总体质量良好。评价体系中的指标可分为5个一级领域、16个二级领域、24个三级领域指标。综合对比各领域对应指标的文献数,卫生资金、效率等领域对应指标的文献数较多,均有20篇左右的文献,高于其他多数领域;投入、产出和结果的相应领域中,近85%的领域对应指标的文献在15篇及以上;服务提供的各领域中,仅18%左右的领域对应指标的文献达到15篇,40%以上领域对应指标的文献未超过5篇。结论农村基本医疗卫生服务综合评价体系对经济效益相关指标关注度较高,投入、产出和结果多数领域的指标重合度较高,评价体系对服务提供领域的关注度较低且内容分散。今后可加强对社会效益和服务提供相关指标的探索,以全面、综合地评价农村基本医疗卫生服务。
文摘Background:The Primary Eyecare Acute Referral Service(PEARS)and the Wales Eye Health Examination(WEHE)operate as enhanced optometry services for patients residing in Wales,enabling the examination of a patient presenting with an acute eye problem(PEARS)or the examination of patients at higher risk of eye disease(WEHE).The purpose of the study is to assess the demographics of patients accessing these services,referral patterns and clinical management in one Health Board in Wales(Aneurin Bevan University Health Board).Methods:Information from 2302 patients accessing the services was prospectively collected.The following information was obtained:type of examination(PEARS or WEHE),patient age,gender,self-referral or general practitioner(GP)referral and clinical management(no further action,monitor by optometrist or ophthalmic medical practitioner[OMP],refer to the Hospital Eye Service[HES],or refer to GP).Results:There were 1791(77.8%)PEARS examinations and 511(22.2%)WEHE.There were 1379(59.9%)females with a mean age of 58.61(±19.75)and 923(40.1%)males with a mean age of 56.11(±20.42).The majority of patients were self-referrals compared to GP-referrals(1793[77.9%]versus 509[22.1%]respectively).Sub-analysis indicated similar numbers of self-referrals compared to GP-referrals for the WEHE only(297[58.1%]versus 214[41.9%]respectively)but greater numbers of self-referrals for the PEARS examinations only(1496[83.5%]versus 295[16.5%]respectively).For management,75%of patients were monitored by their optometrist or OMP,17%required referral to the HES and 8%required referral to their GP.Conclusions:Higher numbers of females accessed both PEARS and WEHE services and the majority of patients self-referred.These findings have important implications for public health campaigns both for targeting specific groups(e.g.male patients)and increasing awareness among GPs.
