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背景目前尚未有初级保健模式在获取优质医疗方面表现出其优越性。本研究对那些可提供优质服务的初级保健站的组织特性进行分析。方法我们对分层随机抽取的加拿大魁北克省3个地区37家初级保健的样本进行了横断面观察研究。本研究一共纳入1 457位接受2种长期护理服务之一或6种幕式护理服务之一的患者(注:幕式护理是指急诊部为有特别问题的人提供的一种医疗及护理服务的模式,医护人员与患者无需建立持续性关系)。主要结果为总技术质量评分。采用了有效调查问卷和团队气氛清单测量组织特性。用多元回归模型做统计学分析。结果以下特性与总医疗技术质量分数紧密相关:医生薪酬分配法〔27.0;95%CI(19.0,35.0)〕、行政资源分享范围〔7.6;95%CI(0.8,14.4)〕、保健辅助人员〔15.3;95%CI(5.4,25.2)〕和/或专科医生〔19.6;95%CI(8.3,30.9)〕的参与、维护或评估能力机制〔7.7;95%CI(3.0,12.4)〕及初级保健站的平均组织使用权〔4.9;95%CI(2.6,7.2)〕。医生人数〔1.2;95%CI(0.6,1.8)〕和团队气氛清单均分〔1.3;95%CI(0.1,2.5)〕与优质医疗相关。解释本研究试图找到初级保健站哪些组织特征与优质医疗有关。我们还竭力发现初级保健质量的测量方法,包括初级保健的综合性(幕式护理、长期护理、预防护理),探讨组织特性的作用在提供保健种类的基础上是如何变化的。
Background Currently no primary health care model has demonstrated its superiority in access to quality health care. This study analyzes the organizational characteristics of primary care stations that provide excellent services. Methods We conducted a cross-sectional study of 37 primary health care samples from three strata randomly stratified stratification in Quebec, Canada. A total of 1 457 patients undergoing either one of two long-term care services or one of six episodic nursing services were included in this study. (Note: Curse care refers to a type of medical and nursing services provided by emergency department to those with special problems Model, healthcare workers and patients do not need to establish a sustained relationship). The main result is the total technical quality score. An effective questionnaire and team atmosphere checklist were used to measure organizational characteristics. Using multiple regression model for statistical analysis. Results The following characteristics were closely related to the total medical technology quality score: the doctor’s remuneration apportionment method [27.0; 95% CI (19.0,35.0)], the scope of administrative resources sharing [7.6; 95% CI (0.8,14.4)], (7.7; 95% CI (3.0, 12.4)] and Primary (15.3; 95% CI (5.4,25.2)] and / or Specialist [19.6; 95% CI (8.3,30.9) The average right to use health care stations [4.9; 95% CI (2.6, 7.2)]. The number of physicians [1.2; 95% CI (0.6, 1.8)] and the team atmosphere checklist (1.3; 95% CI (0.1, 2.5)] were associated with quality medical care. Explain how the study sought to find out which organizational characteristics of primary care stations are related to quality medical care. We also tried to find out how to measure the quality of primary health care, including primary care (episodic care, long-term care, preventive care) and how the role of organizational characteristics can change based on the type of care provided.