Urologists and the patient centered medical home.
Urologists and the patient centered medical home.
复制标题
泌尿科医生和以患者为中心的医疗之家。
DOI：
10.1016/j.juro.2013.03.119
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Hollingsworth,JohnM
中科院分区：
文献类型：
--
作者：
Sakshaug,JosephW;Miller,DavidC;Hollenbeck,BrentK;Wei,JohnT;Hollingsworth,JohnM
目的：人们对以病人为中心的医疗之家所体现的医疗服务制度改革将提高慢性病患者的护理质量寄予厚望。虽然初级保健医生，考虑到他们的培训，很可能是这种模式下的护理中心，但在某些条件下，泌尿科医生非常适合提供以患者为中心的医疗之家所要求的持续和全面的护理。为了评估以泌尿外科为基础的以患者为中心的医疗之家的可行性，我们分析了全国性的调查数据。材料和方法为了衡量医疗之家的基础设施，我们将2007和2008年的NAMCS(国家非卧床医疗护理调查)的项目映射到NCQA(国家质量保证委员会)标准，以识别以患者为中心的医疗之家。我们确定了在美国实现以患者为中心的医疗家庭认可的泌尿外科诊所的比例。最后，我们使用NAMCS的数据来评估巩固泌尿生殖道癌(即前列腺癌、膀胱癌、肾癌和睾丸癌)后续护理在当前泌尿科医生供应中的影响。结果近四分之三的泌尿科实践符合以患者为中心的医疗机构认可的NCQA标准。目前，初级保健医生每周累计工作9,295次，为泌尿生殖系癌症幸存者提供直接和间接护理。在以患者为中心的医疗之家的背景下，将这些护理的一半转移到泌尿外科诊所，将为每个执业泌尿外科医生带来平均0.73个额外的工作周。结论泌尿外科诊所可能具备为其泌尿生殖道癌患者指导医疗之家所需的能力。这一模式的成功实施可能需要有意愿来管理一些非泌尿系疾病。
PurposeHopes are high that the delivery system reforms embodied in the patient centered medical home will improve the quality of care for patients with chronic diseases. While primary care physicians, given their training, will likely be the locus of care under this model, there are certain conditions for which urologists are well suited to provide the continuous and comprehensive care called for by the patient centered medical home. To assess the feasibility of the urology based patient centered medical home, we analyzed national survey data.Materials and MethodsFor our measure of medical home infrastructure, we mapped items from the 2007 and 2008 NAMCS (National Ambulatory Medical Care Survey) to the NCQA (National Committee on Quality Assurance) standards for patient centered medical home recognition. We determined the proportion of urology practices in the United States that would achieve patient centered medical home recognition. Finally, we used NAMCS data to estimate the impact of consolidating genitourinary cancer (ie prostate, bladder, kidney and testis) followup care among the current supply of urologists.ResultsNearly three-quarters of urology practices meet NCQA standards for patient centered medical home recognition. At present, primary care physicians spend 9,295 cumulative workweeks providing direct and indirect care to survivors of genitourinary cancers. Off-loading half of this care to urology practices, in the context of the patient centered medical home, would generate an average of 0.73 additional workweeks for each practicing urologist.ConclusionsUrology practices may possess the capacity needed to direct medical homes for their patients with genitourinary cancers. Successful implementation of this model would likely require a willingness to manage some nonurological conditions.
登录
查看更多内容
基于办公室的医疗实践：全国门诊医疗调查的方法和估计。
DOI：
--
发表时间：
2007
期刊：
Advance data
影响因子：
--
作者：
E. Hing;C. Burt
通讯作者：
C. Burt
影响因子：
9.7
作者：
Rittenhouse, Diane R.;Casalino, Lawrence P.;Drum, Melinda L.
通讯作者：
Drum, Melinda L.
影响因子：
4.4
作者：
Goldberg, Debora Goetz;Kuzel, Anton J.
通讯作者：
Kuzel, Anton J.
影响因子：
120.7
作者：
Grumbach, K;Bodenheimer, T
通讯作者：
Bodenheimer, T
以患者为中心的医疗之家是否有专家的空间？
影响因子：
9.6
作者：
R. Berenson
通讯作者：
R. Berenson