A systematic review of integrated working between care homes and health care services.
A systematic review of integrated working between care homes and health care services.
复制标题
DOI：
10.1186/1472-6963-11-320
复制
发表时间：
2011-11-24
影响因子：
2.8
通讯作者：
Froggatt K
中科院分区：
文献类型：
--
作者：
Davies SL;Goodman C;Bunn F;Victor C;Dickinson A;Iliffe S;Gage H;Martin W;Froggatt K
在英国，疗养院的床位几乎是国民健康服务(NHS)医院床位的三倍。疗养院依靠初级保健来获得医疗保健和专家服务。反复的政策文件和政府审查表明，人们对卫生保健如何与独立提供者合作表示关切，以及需要提高疗养院医疗保健的公平性、连续性和质量。尽管有多项倡议，但尚不清楚一些提供服务的方法是否在促进NHS和疗养院之间的综合工作方面更有效。这项研究旨在评估支持养老院老年人的不同综合保健服务方法，并找出综合工作的障碍和促进者。使用Medline(PubMed)、CINAHL、BNI、EMBASE、CogcINFO、DH Data、Kings Fund、Web of Science(WOS Inc.SCI、SSCI、HCI)和Cochrane图书馆。敢不敢。如果他们评估初级卫生保健专业人员和疗养院之间综合工作的有效性，或者确定综合工作的障碍和促进者，研究就包括在内。对研究进行了质量评估；提取了有关健康、服务使用、成本和过程相关结果的数据。采用一种改进的叙事综合法，运用框架分析的原则对整合进行了比较和对比。包括17项研究：10项定量研究、2项过程评估、1项混合方法研究和4项定性研究。大多数是在养老院进行的。它们的特点是主题、干预措施、方法和结果各不相同。大多数定量研究报告干预的效果有限；没有足够的信息来评估成本。综合工作的促进者包括疗养院经理的支持和工作人员培训的受保护时间。具有综合工作潜力的研究持续时间更长。尽管有证据表明是什么阻碍和促进了综合工作，但关于保健服务和疗养院之间综合保健的不同方法可能会产生什么结果的证据有限。大多数研究只实现了病人一级护理的综合工作，对卫生服务、明确的问题和结果衡量标准的关注没有纳入居民的优先事项或承认疗养院工作人员的技能。需要进行更多研究，以了解综合工作是如何实现的，并测试不同方法对费用、工作人员满意度和驻地工作人员成果的影响。
In the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working. A systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis. Seventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in duration. Despite evidence about what inhibits and facilitates integrated working there was limited evidence about what the outcomes of different approaches to integrated care between health service and care homes might be. The majority of studies only achieved integrated working at the patient level of care and the focus on health service defined problems and outcome measures did not incorporate the priorities of residents or acknowledge the skills of care home staff. There is a need for more research to understand how integrated working is achieved and to test the effect of different approaches on cost, staff satisfaction and resident outcomes.
登录
查看更多内容
影响因子：
2.4
作者：
Goodman, C;Robb, N;Woolley, R
通讯作者：
Woolley, R
影响因子：
4.2
作者：
Goodman, C;Woolley, R;Knight, D
通讯作者：
Knight, D
影响因子：
6.7
作者：
BOND, J;GREGSON, BA;ATKINSON, A
通讯作者：
ATKINSON, A
影响因子：
5.7
作者：
Kane, RL;Flood, S;Keckhafer, G
通讯作者：
Keckhafer, G
影响因子：
3.1
作者：
Hockley, Jo;Dewar, Belinda;Watson, Julie
通讯作者：
Watson, Julie