Transforming Primary Care in Scotland and China to meet the needs of an ageing population - are health inequalities being tackled?

苏格兰和中国的初级保健转型以满足人口老龄化的需求——健康不平等问题是否得到解决？

• 批准号: ES/T014164/1
• 负责人: Stewart Mercer
• 金额: $ 106.13万
• 依托单位: University of Edinburgh
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FT014164%2F1
• 关键词: Transforming; Primary; Care; Scotland; China

Countries around the world are facing major changes, with many people living to an older age. General Practice and primary care provides much of the healthcare care needs of such ageing populations. China and the United Kingdom (UK) share many similar challenges in health and social care including ageing and wide health inequalities between rich and poor. In Scotland, significant recent changes have been made in primary care including a new Scotland-only GP contract which includes GP Practices working together in 'clusters' (of 5-8 Practices) to improve the quality of care delivered to their local population, and significant expansion of other members of the primary care team (such as advanced practitioners in nursing, pharmacy, and physiotherapy). In China, Community Health Centres (CHCs) have been established over recent years. These are similar to GP Practices in Scotland, though somewhat larger, led by GPs working within primary care teams. A key focus - which is much less prominent in Scottish primary care - is systematic preventive care to support people to live healthier lives and manage their own conditions better. There is an important opportunity for each country to learn from each other, as these changes in primary care develop further. The aim of the study is to explore and compare the effects of these recent changes in primary care in Scotland and China, and to find out if these changes are meeting the needs of ageing patients with long-term conditions, as well as reducing health inequalities. To answer this we will carry out the research in two phases. The first phase will explore what the expected impacts are of the changes in both countries. The second phase will examine the actual impacts and key learning. To answer these questions, we will use freely available national information on patients views (available in both countries), together with GPs views on job satisfaction, workload, and the recent organisational changes, which we will collect in both countries. We will also speak in-depth to staff and patients in both countries. We will do this in a range of different geographical settings to get more detailed information on their views, and analyse these in terms of common themes, and what has been found to help or hinder progress. We will supplement these findings with routine data recorded in the computerised medical records in both countries. We will then consider the implications of the findings for both countries, and share the findings with the public, government, healthcare staff, and other researchers. The findings may also be of interest to other countries that are embarking on similar attempts to improve primary care to meet the needs of ageing populations, and help tackle health inequalities. A unique feature of the research will be collaboration between researchers with different areas of expertise, in social and medical research.

世界各国都面临着重大变化，许多人活到了老年。全科医疗和初级保健提供了这些老龄化人口的大部分医疗保健需求。中国和英国在卫生和社会保健方面面临着许多相似的挑战，包括老龄化和贫富之间广泛的健康不平等。在苏格兰，最近在初级保健方面进行了重大改革，包括一项新的苏格兰全科医生合同，其中包括全科医生诊所在“集群”（5-8个诊所）中共同努力，以提高向当地人口提供的护理质量，以及初级保健团队其他成员（如护理，药学和物理治疗方面的高级从业人员）的显著扩张。在中国，社区卫生中心（CHCs）近年来已经建立。这些做法类似于苏格兰的全科医生做法，但规模更大，由在初级保健团队工作的全科医生领导。一个关键的重点--在苏格兰初级保健中不那么突出--是系统的预防保健，以支持人们过上更健康的生活，更好地管理自己的状况。随着初级保健领域的这些变化进一步发展，每个国家都有一个相互学习的重要机会。这项研究的目的是探索和比较苏格兰和中国初级保健的这些最新变化的影响，并找出这些变化是否满足长期疾病的老年患者的需求，以及减少健康不平等。为了回答这个问题，我们将分两个阶段进行研究。第一阶段将探讨两国变化的预期影响。第二阶段将审查实际影响和主要经验教训。为了回答这些问题，我们将使用免费提供的关于患者意见的国家信息（两国都有），以及我们将在两国收集的关于工作满意度，工作量和最近组织变化的全科医生意见。我们还将与两国的工作人员和患者深入交谈。我们将在一系列不同的地理环境中这样做，以获得关于他们的观点的更详细的信息，并从共同主题的角度分析这些观点，以及发现哪些有助于或阻碍进展。我们将用两国计算机化医疗记录中记录的常规数据来补充这些发现。然后，我们将考虑研究结果对两国的影响，并与公众，政府，医疗保健人员和其他研究人员分享研究结果。这些发现可能也会引起其他国家的兴趣，这些国家正在采取类似的措施来改善初级保健，以满足老龄化人口的需求，并帮助解决健康不平等问题。这项研究的一个独特之处将是社会和医学研究领域不同专业领域的研究人员之间的合作。

项目成果

Primary care transformation in Scotland: qualitative evaluation of the views of patients.

苏格兰的初级保健转型：对患者观点的定性评估。

• DOI: 10.3399/bjgp.2023.0437
• 发表时间: 2024
• 期刊: the journal of the Royal College of General Practitioners
• 作者: Donaghy E

Children's understanding of epilepsy: A qualitative study.

儿童对癫痫的理解：一项定性研究。

• DOI: 10.1016/j.yebeh.2021.107994
• 发表时间: 2021-07
• 期刊: Epilepsy & behavior : E&B
• 作者: Harden J;Black R;Pickersgill M;Shetty J;McLellan A;Brand C;Small M;McDonnell J;Clarke L;Chin RF
• 通讯作者: Chin RF

Is monkeypox an STI? The societal aspects and healthcare implications of a key question

猴痘是性传播感染吗？

• DOI: 10.12688/wellcomeopenres.18436.1
• 发表时间: 2022
• 期刊: Wellcome Open Research
• 作者: Garcia Iglesias J

The benefits, costs and feasibility of a low incidence COVID-19 strategy.

• DOI: 10.1016/j.lanepe.2021.100294
• 发表时间: 2022-03
• 期刊: The Lancet regional health. Europe
• 作者: Czypionka T;Iftekhar EN;Prainsack B;Priesemann V;Bauer S;Calero Valdez A;Cuschieri S;Glaab E;Grill E;Krutzinna J;Lionis C;Machado H;Martins C;Pavlakis GN;Perc M;Petelos E;Pickersgill M;Skupin A;Schernhammer E;Szczurek E;Tsiodras S;Willeit P;Wilmes P
• 通讯作者: Wilmes P

Understanding primary care transformation and implications for ageing populations and health inequalities: a systematic scoping review of new models of primary health care in OECD countries and China.

• DOI: 10.1186/s12916-023-03033-z
• 发表时间: 2023-08-24
• 期刊: BMC MEDICINE
• 影响因子: 9.3
• 作者: Henderson, D. A. G.;Donaghy, E.;Dozier, M.;Guthrie, B.;Huang, H.;Pickersgill, M.;Stewart, E.;Thompson, A.;Wang, H. H. X.;Mercer, S. W.
• 通讯作者: Mercer, S. W.