Defining the Role and Value of Physicians Who Primarily Practice in Nursing Homes: Perspectives of Nursing Home Physicians.
Defining the Role and Value of Physicians Who Primarily Practice in Nursing Homes: Perspectives of Nursing Home Physicians.
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DOI：
10.1016/j.jamda.2022.03.008
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发表时间：
2022-06
影响因子：
7.6
通讯作者：
Katz, Paul R.
中科院分区：
文献类型：
--
作者：
Jung, Hye-Young;Yun, Hyunkyung;O'Donnell, Eloise;Casalino, Lawrence P.;Unruh, Mark Aaron;Katz, Paul R.
为了确定拥有养老院护理专业知识的医生对主要在养老院执业的医生(通常被称为“SNFist”)的价值的看法，目的是丰富我们对养老院护理专业化的理解。半结构化访谈的定性分析。2021年1月18日至29日进行了虚拟采访。参与者包括美国各地的35名医生，他们现在或以前在养老院担任医疗主任或主治医生。采访是在Zoom上进行的，并经过专业转录。成果是专题分析产生的主题。参与者平均有19.5年[SD=11.3]年在养老院工作的经验；17(48.6%)是女性；最常见的医学专业是老年科(18[51.4%])、家庭医学(8[22.9%])、内科(7[20.0%])、物理(1[2.9%])和肺科(1[2.9%])。有10名(28.6%)的参与者是SNFI。我们确定了参与者强调的六个主题：1)SNFist的定义不明确和资格松散可能会影响护理质量；2)需要特定的能力才能成为“好的SNFist”；3)SNFist因其独特的实践方法而异，通常提供不收费或报销不足的服务；4)SNFist取得更好的结果，但对绩效衡量标准意见不一；5)SNFist可能导致护理中断；6)SNFist在新冠肺炎大流行期间仍留在NHS。在疗养院护理方面拥有专业知识的医生中有一个强烈的共识，即SNFist为住院医生提供比其他医生更高质量的护理。然而，除了标准化的业绩衡量外，还需要基于能力的SNFist的统一定义。不收费和报销不足的服务阻碍了医生成为SNFist。政策制定者可以考虑修改医疗保险报销制度，以激励更多的医生专门从事养老院护理。·疗养院护理专家认为，SNFist为住院医生提供了比其他医生更高质量的护理，但需要根据能力和标准化的绩效衡量标准统一定义SNFist。
To identify the perceptions of physicians with expertise in nursing home care on the value of physicians who primarily practice in nursing homes, often referred to as “SNFists,” with the goal of enriching our understanding of specialization in nursing home care. Qualitative analysis of semi-structured interviews. Virtual interviews conducted January 18–29, 2021. Participants included 35 physicians across the United States, who currently or previously served as medical directors or attending physicians in nursing homes. Interviews were conducted virtually on Zoom and professionally transcribed. Outcomes were themes resulting from thematic analysis. Participants had a mean 19.5 [SD = 11.3] years of experience working in nursing homes; 17 (48.6%) were female; the most common medical specializations were geriatrics (18 [51.4%]), family medicine (8 [22.9%]), internal medicine (7 [20.0%]), physiatry (1 [2.9%]), and pulmonology (1 [2.9%]). Ten (28.6%) participants were SNFists. We identified six themes emphasized by participants: 1) An unclear definition and loose qualifications for SNFists may affect the quality of care; 2) Specific competencies are needed to be a “good SNFist;” 3) SNFists are distinguished by their unique practice approach and often provide services that are unbillable or under-reimbursed; 4) SNFists achieve better outcomes, but opinions varied on performance measures; 5) SNFists may contribute to discontinuity of care; 6) SNFists remained in NHs during the COVID-19 pandemic. There is a strong consensus among physicians with expertise in nursing home care that SNFists provide higher quality care for residents than other physicians. However, a uniform definition of a SNFist based on competencies in addition to standardized performance measures are needed. Unbillable and under-reimbursed services create disincentives to physicians becoming SNFists. Policymakers may consider modifying Medicare reimbursements to incentivize more physicians to specialize in nursing home care. •Experts in nursing home care believe that SNFists provide higher quality care for residents than other physicians, but a uniform definition of a SNFist based on competencies and standardized performance measures are needed.
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DOI：
10.1016/j.jamda.2018.08.001
发表时间：
2018-10-01
影响因子：
7.6
作者：
Mays, Allison Moser;Saliba, Debra;Katz, Paul R.
通讯作者：
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影响因子：
158.5
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DOI：
10.1046/j.1532-5415.2002.50610.x
发表时间：
2002-12-01
影响因子：
6.3
作者：
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通讯作者：
Magaziner, J
DOI：
10.1111/j.1532-5415.1997.tb02958.x
发表时间：
1997-08-01
影响因子：
6.3
作者：
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