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目的以患者为中心的医疗之家(PCMH)服务可以改善当前的全科医疗服务,但究竟何种PCMH服务模式可以获得特定的服务效果尚不明确。本研究旨在采用一种新的方法——PCMH模式分类法,对PCMH服务模式进行分类并评估其服务效果。方法对《2012—2013年以患者为中心的全科医疗协作服务年度综述》中PCMH相关文献报道的59家PCMH数据进行二次分析。将PCMH服务模式分为4类,分别为:附加型、革新型、混合型、综合型。每家PCMH均从6个方面进行评估,包括降低成本、减少使用急诊/医院服务、服务质量改进、服务便利性改进、预防服务改进、患者满意度改进。各类型PCMH的每个方面平均得分均采用雷达图表示,并进行比较。结果尽管各类型PCMH均显示出其在某方面的独特优势,但仅综合型PCMH在全部6个方面均得到了改进。然而,任何一种PCMH服务模式都没有在全部6个方面获得佳绩。讨论共有4种类型的PCMH,每种类型均有其独特优势。对PCMH服务模式进行分类,可以为以最佳方式改善全科医疗服务并获得最好效果指明方向。
The Purpose The patient-centered Medical Home (PCMH) service can improve current general practitioner services, but it is unclear exactly what the PCMH service model can achieve for a given service. The purpose of this study is to use a new method, the PCMH pattern classification, to classify PCMH service patterns and evaluate their service effectiveness. Methods A total of 59 PCMH data reported in the relevant literature of PCMH in the annual review of patient-centered GP services in 2012-2013 were analyzed. The PCMH service mode is divided into four categories, namely: additional, innovative, hybrid, integrated. Each PCMH was evaluated in six areas, including cost reduction, reduced use of emergency / hospital services, improved service quality, improved service convenience, improved prevention services, and improved patient satisfaction. The average scores for each aspect of each type of PCMH are plotted using radar charts and compared. Results Although each type of PCMH shows its unique advantages in one area, only the comprehensive PCMH has been improved in all six areas. However, none of the PCMH service models achieved any success in all six areas. There are a total of 4 types of PCMH discussed, each with its own unique advantages. Classifying the PCMH service model can point you to the best ways to improve your GP and get the best results.