Reorganizing pediatric rehabilitation services to improve accessibility: do we sacrifice quality?
Reorganizing pediatric rehabilitation services to improve accessibility: do we sacrifice quality?
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DOI：
10.1186/1472-6963-10-227
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发表时间：
2010-08-05
影响因子：
2.8
通讯作者：
Brodeur, Marie-Michele
中科院分区：
文献类型：
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作者：
Camden, Chantal;Swaine, Bonnie;Brodeur, Marie-Michele
背景：评估了儿科康复服务提供重组以改善获得服务的机会对父母和服务提供者对服务质量的感知的影响。方法：在服务重组前(2007)、服务重组期间(2008)和服务重组后(2009)，使用护理工具和开放式问题的过程测量感知。记录了儿童和家庭特征、接受的服务和服务提供者的数据。结果：2007年，家庭(n=222)和服务提供商(n=129)对服务质量的感知较高(3.67~6.31/7)，并在接下来的两年(p=0.16)保持较高水平(p=0.16)。两个MPOC领域(尊重关怀和提供一般信息)得分持续最高(平均值=5.66/7)和最低(平均值=4.75/7)。受教育程度较高的家庭和有12-21岁孩子的家庭倾向于归因于较低的MPOC分数。参与者对新的服务模式总体满意，建议包括加强信息交流。结论：结果表明，在保持质量的情况下，重组儿科康复服务是可能的。
Background: The impact of a pediatric rehabilitation service delivery reorganization to improve access to services on parents' and service providers' perception of service quality was evaluated. Child-, family-, service- and service provider-related characteristics possibly associated with these perceptions were explored.Methods: Perceptions were measured using the Measure of Processes of Care tools and open ended questions before (2007), during (2008) and following (2009) service reorganization. Child and family characteristics, services received and service provider data were documented. Mean MPOC scores were compared over time (ANOVAs and Generalized Estimating Equations) and t-tests, correlations and ANOVAs determined whether the characteristics influenced scores.Results: Families' (n = 222) and service providers' (n = 129) perceptions of quality were high in 2007 (3.67 to 6.31/7) and remained high over the next 2 years (p = 0.16). Two MPOC domain scores (Respectful care and Providing general information) were consistently scored the highest (mean = 5.66/7) and the lowest (mean = 4.75/7), respectively. Families with more education and those with children 12-21 years old tended to attribute lower MPOC scores. Participants were generally satisfied with the new service model and recommendations included improving information exchange.Conclusions: Results suggest that it is possible to reorganize pediatric rehabilitation services while maintaining quality.