Innovations in access to care: A patient-centered approach
Innovations in access to care: A patient-centered approach
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DOI：
10.7326/0003-4819-139-7-200310070-00009
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发表时间：
2003-10-07
影响因子：
39.2
通讯作者：
Wilder, SS
中科院分区：
文献类型：
--
作者：
Berry, LL;Seiders, K;Wilder, SS
为了获得医疗保健，非紧急问题的患者必须获得一个复杂的，相互依赖的门诊护理系统，目前围绕传统的办公室预约模式。该系统无法有效满足不同患者的需求和偏好，导致医疗保健资源的过度使用和利用不足。以患者为中心的访问模式将帮助患者在需要时获得适当和首选的医疗援助。以患者为中心的访问的特征包括可用性，适当性，偏好和及时性。这些特征中的一个或多个往往是缺失的患者的医疗保健experiences. This本文的目标是目前以患者为中心的访问作为一个综合的概念和哲学，提供评估具体的访问倡议的背景。在评估现有文献的基础上，提出并讨论了以患者为中心的访问的3个组织原则：在专业知识的高端工作;根据需要和偏好调整护理;以及在需要服务时提供服务。考虑到患者、提供者和支付者的利益，以患者为中心的访问值得认真考虑。很少有概念支持医学研究所21世纪世纪的所有6个目标：安全性，有效性，以患者为中心，及时性，效率和公平性。以患者为中心的访问就是这样一个概念。
To receive health care, patients with nonemergent problems must gain access to a complex, interdependent ambulatory care system currently structured around the conventional office appointment model. The system does not effectively accommodate diverse patient needs and preferences, contributing to both overuse and underuse of health care resources. A patient-centered access model would help patients secure appropriate and preferred medical assistance when and where it is needed. Characteristics of patient-centered access include availability, appropriateness, preference, and timeliness. One or more of these characteristics often is missing in patients' health care experiences.The goal of this paper is to present patient-centered access as an integrated concept and philosophy to provide context for evaluating specific access initiatives. on the basis of an assessment of existing literature, 3 organizing principles of patient-centered access are proposed and discussed: work at the high end of expertise; align care with need and preference; and serve when service is needed. Patient-centered access warrants serious consideration, given the stakes involved for patients, providers, and payers. Few concepts support all 6 of the Institute of Medicine's aims for the 21st century: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equitability. Patient-centered access is such a concept.