Communities as ‘renewable energy’ for healthcare services? a multimethods study into the form, scale and role of voluntary support for community hospitals in England
Communities as ‘renewable energy’ for healthcare services? a multimethods study into the form, scale and role of voluntary support for community hospitals in England
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社区作为医疗保健服务的“可再生能源”？对英格兰社区医院自愿支持的形式、规模和作用的多方法研究
作者：
Angela Ellis Paine;D. Kamerāde;J. Mohan;D. Davidson
目的考察英国社区和志愿者对社区医院的支持形式、规模和作用。设计：多方法研究。对慈善委员会关于支持社区医院的慈善机构的志愿服务和自愿收入水平的数据进行定量分析。九个社区医院及其周边社区的定性案例研究，包括访谈和焦点小组。设置英格兰及其周边社区的社区医院。参与者慈善委员会的数据为245个社区医院之友联盟。与工作人员（89）、病人（60）、照顾者（28）、志愿者（35）、社区代表（20）、管理人员和专员（9）进行了访谈。多学科小组的焦点小组（9个地点的8个小组，涉及43名答卷人）、志愿人员（6个小组，33名答卷人）和社区利益攸关方（8个小组，54名答卷人）。结果社区通过以下方式支持社区医院：人力资源（平均每家医院每年24名志愿者）;财政资源（志愿收入中位数= 15632英镑）;通过志愿者和社区团体提供的服务和活动提供的实用资源;和智力资源（例如，咨询和合作生产）。社区为国家保健服务提供了宝贵的补充资源，加强了社区医院服务、病人的经验、工作人员的士气和志愿人员的福利。然而，这种资源的水平和形式因医院而异，而且随着时间的推移而有所不同：志愿收入在减少，朋友联盟的成员也在减少，而且很难招募到经常性的积极志愿人员。结论社区可以成为医疗服务的重要资源，可以提高患者体验和服务质量。然而，利用这种资源并不是一件简单的事情，人们认为，质疑这种资源在多大程度上可以被视为可持续或“可再生”资源可能会变得越来越困难。
Objective To examine the forms, scale and role of community and voluntary support for community hospitals in England. Design A multimethods study. Quantitative analysis of Charity Commission data on levels of volunteering and voluntary income for charities supporting community hospitals. Nine qualitative case studies of community hospitals and their surrounding communities, including interviews and focus groups. Setting Community hospitals in England and their surrounding communities. Participants Charity Commission data for 245 community hospital Leagues of Friends. Interviews with staff (89), patients (60), carers (28), volunteers (35), community representatives (20), managers and commissioners (9). Focus groups with multidisciplinary teams (8 groups across nine sites, involving 43 respondents), volunteers (6 groups, 33 respondents) and community stakeholders (8 groups, 54 respondents). Results Communities support community hospitals through: human resources (average=24 volunteers a year per hospital); financial resources (median voluntary income = £15 632); practical resources through services and activities provided by voluntary and community groups; and intellectual resources (eg, consultation and coproduction). Communities provide valuable supplementary resources to the National Health Service, enhancing community hospital services, patient experience, staff morale and volunteer well-being. Such resources, however, vary in level and form from hospital to hospital and over time: voluntary income is on the decline, as is membership of League of Friends, and it can be hard to recruit regular, active volunteers. Conclusions Communities can be a significant resource for healthcare services, in ways which can enhance patient experience and service quality. Harnessing that resource, however, is not straight forward and there is a perception that it might be becoming more difficult questioning the extent to which it can be considered sustainable or ‘renewable’.