长期照护中质量和结果框架的作用:系统评价

发布时间：2018-12-13 10:34

【摘要】：背景改善患者的长期照护质量是NHS政策的核心。质量和结果框架(QOF)是对需长期照护患者采取有效干预措施的初级护理绩效奖励方案。该方案被认为并不能提高长期照护质量。目的查证QOF是否能够提高长期照护质量。设计与场所英国QOF有效性研究系统评价。方法通过检索电子数据库进行同行评议的实证定量研究,探索QOF对长期照护质量的影响,其中包括护理协调和整合、全人和个人护理、自我护理、患者体验、生理和生化结果、卫生服务利用率及病死率。由于研究是异构的,所以进行了叙述性合成。结果确定了符合纳入标准的3个系统评价和5个初步研究。QOF与急症住院人数增加有所放缓、重性精神疾病(SMI)咨询人数增加有所放缓、糖尿病护理有所改善相关。证据的性质无法确定这些关联是否具有因果关系。未发现QOF对病死率的明显影响。QOF对护理协调和整合、全人护理、自我护理和患者体验无影响。结论 NHS应更广泛地考虑高质量长期照护的影响因素以及其他激励方式。
[Abstract]:Background improving long-term care quality of patients is the core of NHS policy. The quality and results Framework (QOF) is a primary care performance reward scheme for patients requiring long term care. The scheme is not considered to improve the quality of long-term care. Objective to verify whether QOF can improve the quality of long-term care. Design and site Evaluation of QOF effectiveness Research system in UK. Methods the effects of QOF on long-term care quality, including nursing coordination and integration, whole-person and personal nursing, self-care, patient experience, physiological and biochemical results, were investigated by peer-reviewed empirical quantitative study by searching electronic database. Health service utilization and mortality. Since the study is heterogeneous, narrative synthesis is carried out. Results three systematic evaluations and five preliminary studies according to the inclusion criteria were confirmed. The increase of QOF was related to the increase of emergency hospitalization, the increase of (SMI) counseling and the improvement of diabetes care. The nature of the evidence does not determine whether these associations are causal. No significant effect of QOF on mortality was found. QOF had no effect on nursing coordination and integration, holistic nursing, self-care and patient experience. Conclusion NHS should consider more widely the influencing factors of high-quality long-term care and other incentives.
【分类号】：R47

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