Association of a Multisite Interprofessional Education Initiative With Quality of Primary Care
Association of a Multisite Interprofessional Education Initiative With Quality of Primary Care
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DOI：
10.1001/jamanetworkopen.2019.15943
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发表时间：
2019-11-01
影响因子：
13.8
通讯作者：
Tuepker, Anais
中科院分区：
文献类型：
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作者：
Edwards, Samuel T.;Hooker, Elizabeth R.;Tuepker, Anais
重要性 研究表明，跨专业教育 (IPE) 可以提高学习者的熟练程度，但很少有人测量 IPE 与患者结果（例如临床质量）的关联。 目的 评估多地点 IPE 计划与护理质量的关联。 设计、设置和参与者 本研究使用了美国退伍军人事务部 (VA) 2008 年 7 月 1 日至 6 月电子健康记录数据的双重差分分析2015 年 2 月 30 日。使用 3 个学年（即 7 月 1 日至 6 月 30 日）的数据，将参加初级保健教育卓越中心 (CoEPCE) 的 5 个退伍军人事务部学术初级保健诊所的住院医生照顾的患者与 5 个地区匹配的非 CoEPCE 诊所的住院医生照顾的患者进行比较，CoEPCE 是一项旨在促进医生、执业护士、药剂师和心理学家实习生中 IPE 的计划。 CoEPCE 启动后 4 个学年。分析于2018年1月18日至2019年1月17日进行。主要结果和措施在糖尿病患者中，结果包括年度血红蛋白A1c、血红蛋白A1c控制不佳（即，
IMPORTANCE Studies have shown that interprofessional education (IPE) improves learner proficiencies, but few have measured the association of IPE with patient outcomes, such as clinical quality.OBJECTIVE To estimate the association of a multisite IPE initiative with quality of care.DESIGN, SETTING, AND PARTICIPANTS This study used difference-in-differences analysis of US Department of Veterans Affairs (VA) electronic health record data from July 1, 2008, to June 30, 2015. Patients cared for by resident clinicians in 5 VA academic primary care clinics that participated in the Centers of Excellence in Primary Care Education (CoEPCE), an initiative designed to promote IPE among physician, nurse practitioner, pharmacist, and psychologist trainees, were compared with patients cared for by resident clinicians in 5 regionally matched non-CoEPCE clinics using data for the 3 academic years (ie, July 1 to June 30) before and 4 academic years after the CoEPCE launch. Analysis was conducted from January 18, 2018, to January 17, 2019.MAIN OUTCOMES AND MEASURES Among patients with diabetes, outcomes included annual hemoglobin A1c, poor hemoglobin A1c control (ie,