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首页> 美国卫生研究院文献>International Journal of Environmental Research and Public Health >Cohort Profile: Effectiveness of a 12-Month Patient-Centred Medical Home Model Versus Standard Care for Chronic Disease Management among Primary Care Patients in Sydney Australia
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Cohort Profile: Effectiveness of a 12-Month Patient-Centred Medical Home Model Versus Standard Care for Chronic Disease Management among Primary Care Patients in Sydney Australia

机译：队列资料：澳大利亚悉尼市以12个月为中心的以患者为中心的医疗之家模型与标准治疗在慢性病管理中的有效性

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Evidence suggests that patient-centred medical home (PCMH) is more effective than standard general practitioner care in improving patient outcomes in primary care. This paper reports on the design, early implementation experiences, and early findings of the 12-month PCMH model called ‘WellNet’ delivered across six primary care practices in Sydney, Australia. The WellNet study sample comprises 589 consented participants in the intervention group receiving enhanced primary care in the form of patient-tailored chronic disease management plan, improved self-management support, and regular monitoring by general practitioners (GPs) and trained clinical coordinators. The comparison group consisted of 7750 patients who were matched based on age, gender, type and number of chronic diseases who received standard GP care. Data collected include sociodemographic characteristics, clinical measures, and self-reported health assessments at baseline and 12 months. Early study findings show the mean age of the study participants was 70 years with nearly even gender distribution of males (49.7%) and females (50.3%). The most prevalent chronic diseases in descending order were circulatory system disorders (69.8%), diabetes (47.4%), musculoskeletal disorders (43.5%), respiratory diseases (28.7%), mental illness (18.8%), and cancer (13.6%). To our knowledge, the WellNet study is the first study in Australia to generate evidence on the feasibility of design, recruitment, and implementation of a comprehensive PCMH model. Lessons learned from WellNet study may inform other medical home models in Australian primary care settings.
机译：有证据表明，以患者为中心的医疗之家（PCMH）在改善初级保健中的患者预后方面比标准的全科医生更为有效。本文报告了在澳大利亚悉尼的六个初级保健实践中提供的名为“ WellNet”的12个月PCMH模型的设计，早期实施经验和早期发现。 WellNet研究样本包括干预组中的589名同意参与的参与者，这些参与者以患者量身定制的慢性病管理计划，增强的自我管理支持以及由全科医生（GPs）和训练有素的临床协调员进行定期监测的形式接受了加强的初级保健。对照组由7750名患者组成，这些患者根据年龄，性别，慢性疾病的类型和数量进行了匹配，并接受了标准的GP护理。收集的数据包括社会人口学特征，临床措施以及在基线和12个月时自我报告的健康评估。早期研究发现，研究参与者的平均年龄为70岁，男性（49.7％）和女性（50.3％）的性别分布几乎均匀。慢性疾病中按降序排列最普遍的是循环系统疾病（69.8％），糖尿病（47.4％），肌肉骨骼疾病（43.5％），呼吸系统疾病（28.7％），精神疾病（18.8％）和癌症（13.6％） 。据我们所知，WellNet研究是澳大利亚进行的第一项研究，旨在为设计，招募和实施全面的PCMH模型提供可行性证据。从WellNet研究中吸取的教训可能会为澳大利亚初级保健机构中的其他医疗家庭模式提供参考。

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