文章基本信息
- 标题：Scaling-up an Integrated Care for Patients with Non-communicable Diseases: An Analysis of Healthcare Barriers and Facilitators in Slovenia and Belgium
- 本地全文：下载
- 作者：Črt Zavrnik ; Katrien Danhieux ; Miriam Hurtado Monarres 等
- 期刊名称：Slovenian Journal of Public Health
- 印刷版ISSN：0351-0026
- 电子版ISSN：1854-2476
- 出版年度：2021
- 卷号：60
- 期号：3
- 页码：158-166
- DOI：10.2478/sjph-2021-0023
- 语种：English
- 出版社：Walter de Gruyter GmbH
- 摘要：Abstract Introduction Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium. Methods This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries. Results Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals. Conclusions This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.
- 其他摘要：
sl Izvleček Uvod Celostna oskrba kroničnih nenalezljivih bolezni je koncept, ki v bolezen usmerjeno oskrbo nadomešča z oskrbo, usmerjeno na pacienta. Kljub obstoju učinkovitega modela takšne obravnave pa je bil slednji v evropskih državah doslej uveden le delno. Namen te študije je prepoznati in primerjati spodbujevalce in ovire za nadgradnjo celostne oskrbe v Sloveniji in Belgiji.
Metode V sklopu te kvalitativne študije je bilo izvedenih 15 fokusnih skupin in 51 intervjujev z odločevalci na mikro-, mezo- in makroravni. Poleg tega so bili v analizo vključeni tudi podatki iz dveh predhodno objavljenih študij. Zbiranje podatkov in analiza sta bila sprva izvedena v vsaki državi ločeno, nato pa je mednarodna ekipa raziskovalcev primerjala podatke ter opredelila razlike in podobnosti med državama.
Rezultati V raziskavi so bile izpostavljene štiri teme: na pacienta usmerjena oskrba, timsko delo, koordinacija oskrbe ter prenos zadolžitev med zdravstvenimi delavci. Odločevalci obeh držav so izpostavili, da vzpostavljena močna hierarhija in strog medicinski pristop k obravnavi pacientov s kronično boleznijo predstavlja bistveno oviro za uresničitev resničnega timskega dela in na pacienta usmerjene oskrbe. V nasprotju z Belgijo organizacija primarnega zdravstvenega varstva v Sloveniji najverjetneje spodbuja koordinacijo oskrbe. V Belgiji pa sta bila kot bistvena ovira za prenos zadolžitev med zdravstvenimi delavci izpostavljena način financiranja in organizacija primarnih ambulant.
Zaključki Ta študija predstavlja nekaj za prihodnost pomembnih načel obravnave kroničnih nenalezljivih bolezni na primarni zdravstveni ravni. Rezultati lahko predstavljajo uporabna spoznanja za druge države s podobnim zdravstvenim sistemom.
- 关键词：scale-up;noncommunicable diseases;patient-centered care;primary healthcare;integrated healthcare
