Emergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands - Analyzing organization, payment and reforms
Emergency and urgent care systems in Australia, Denmark, England, France, Germany and the Netherlands - Analyzing organization, payment and reforms
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DOI：
10.1016/j.healthpol.2018.11.001
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发表时间：
2019-01-01
期刊：
影响因子：
3.3
通讯作者：
Quentin, Wilm
中科院分区：
文献类型：
--
作者：
Baier, Natalie;Geissler, Alexander;Quentin, Wilm
引言：越来越多的医院急诊（艾德）就诊对许多国家的卫生系统构成了挑战。本文旨在研究紧急和紧急护理系统，在六个国家，并确定改革趋势，以应对当前的挑战。方法：根据文献回顾，六个国家-澳大利亚，丹麦，英国，法国，德国和荷兰-被选中进行分析。收集资料时使用了由各国专家填写的标准化调查表。这些专家审查了相关的政策文件，并提供了以下方面的信息：（1）紧急情况和紧急护理的组织和规划;（2）急诊科医生和紧急初级保健提供者的支付系统;（3）改革举措。（a）扩大提供紧急初级保健，（B）集中和集中提供紧急初级保健，（c）改善紧急初级保健和紧急保健之间的协调，以及（d）将紧急护理服务集中在较少的机构提供。紧急初级保健和紧急护理的支付系统的设计往往是一致的，以支持这些reforms.Conclusion：更好地指导病人和紧急和紧急护理的重新配置是最重要的措施，以解决当前的挑战。对所有紧急护理提供者进行全国性规划，密切协调改革并告知患者，可以支持未来的改革。(C)2018作者（S）由爱思唯尔公司出版
Introduction: Increasing numbers of hospital emergency department (ED) visits pose a challenge to health systems in many countries. This paper aims to examine emergency and urgent care systems, in six countries and to identify reform trends in response to current challenges.Methods: Based on a literature review, six countries - Australia, Denmark, England, France, Germany and the Netherlands - were selected for analysis. Information was collected using a standardized questionnaire that was completed by national experts. These experts reviewed relevant policy documents and provided information on (1) the organization and planning of emergency and urgent care, (2) payment systems for EDs and urgent primary care providers, and (3) reform initiatives.Results: In the six countries four main reform approaches could be identified: (a) extending the availability of urgent primary care, (b) concentrating and centralizing the provision of urgent primary care, (c) improving coordination between urgent primary care and emergency care, and (d) concentrating emergency care provision at fewer institutions. The design of payment systems for urgent primary care and for emergency care is often aligned to support these reforms.Conclusion: Better guidance of patients and a reconfiguration of emergency and urgent care are the most important measures taken to address the current challenges. Nationwide planning of all emergency care providers, closely coordinated reforms and informing patients can support future reforms. (C) 2018 The Author(s). Published by Elsevier B.V.