AGnES: Supporting General Practitioners With Qualified Medical Practice Personnel Model Project Evaluation Regarding Quality and Acceptance
AGnES: Supporting General Practitioners With Qualified Medical Practice Personnel Model Project Evaluation Regarding Quality and Acceptance
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DOI：
10.3238/arztebl.2009.0003
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发表时间：
2009-01-05
影响因子：
7.7
通讯作者：
Hoffmann, Wolfgang
中科院分区：
文献类型：
--
作者：
Van den Berg, Neeltje;Meinke, Claudia;Hoffmann, Wolfgang
背景资料：德国的AGNES（基于社区的、电子保健辅助的初级保健系统支持）项目允许全科医生将医疗保健的某些内容，包括上门服务，委托给合格的AGNES员工，从而为更多的患者提供初级保健。从2005年起，在德国的一些联邦州实施了AGnES的各种项目。在这篇文章中，评估的AGnES项目迄今为止。方法：患者数据（年龄，性别，诊断，护理水平，流动性等）。在AGnES框架内开展的每一项具体活动都用标准化的计算机工具记录下来。全科医生、AGNES员工和患者也接受了标准化访谈。对AGNES项目的验收、AGNES员工的能力以及项目内的医疗护理质量进行了评价。参与的全科医生自己评估的质量的医疗care.Results：到2008年7月8日，8386家共1486名患者的AGNES项目的框架内进行了访问。评估显示，参与的全科医生，AGNES员工和患者对该项目的接受程度很高。全科医生认为AGNES项目内的医疗质量是好的，为绝大多数patients.Conclusion：结构冗余避免直接放置在全科医生的做法的AGNES员工。根据AGNES项目的结果，德国现已修订法律，以便从2009年1月起在常规保健系统中实施AGNES项目。接下来要采取的步骤是在法定健康保险计划的目录中确定适当的报销，并详细定义所需的资格。
Background: The German AGnES (community-based, e-health-assisted systemic support for primary care) project allows general practitioners (GPs) to delegate certain elements of medical care, including house calls, to qualified AGnES employees and thereby provide primary care to a larger number of patients. AGnES projects of various types have been carried out in a number of German federal states from 2005 onward. In this article, an evaluation of the AGnES projects to date is presented.Methods: Patient data (age, sex, diagnoses, level of care, mobility, etc.) and each of the specific activities carried out in the AGnES framework were documented with standardized computer-based instruments. The GPs, AGnES employees, and patients also underwent standardized interviews. The acceptance of the AGnES project, competence of the AGnES employees, and quality of medical care within the projects were evaluated. The participating GPs themselves assessed the quality of medical care.Results: By July 8, 2008, 8386 house calls on a total of 1486 patients had been made within the framework of the AGnES projects. The evaluation revealed a high degree of acceptance of the project among the participating GPs, AGnES employees, and patients. The GPs considered the quality of medical care within the AGnES project to be good for the vast majority of patients.Conclusion: Structural redundancy is avoided by directly placing the AGnES employees in the general practitioners' practices. Based on the results of the AGnES projects, the law in Germany has now been amended to enable implementation of the AGnES project in the regular health care system from January 2009 onward. The next steps to be taken are the establishment of adequate reimbursement within the catalog of the statutory health insurance scheme and a detailed definition of the required qualifications.