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首页> 外文期刊>BMC Health Services Research >Patient initiated clinics for patients with chronic or recurrent conditions managed in secondary care: a systematic review of patient reported outcomes and patient and clinician satisfaction
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Patient initiated clinics for patients with chronic or recurrent conditions managed in secondary care: a systematic review of patient reported outcomes and patient and clinician satisfaction

机译：由二级医疗机构管理的患有慢性或复发性疾病的患者开办的诊所：对患者报告的结局以及患者和临床医生满意度的系统评价

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Background The cost to the NHS of missed or inappropriate hospital appointments is considerable. Alternative methods of appointment scheduling might be more flexible to patients’ needs without jeopardising health and service quality. The objective was to systematically review evidence of patient initiated clinics in secondary care on patient reported outcomes among patients with chronic/recurrent conditions. Methods Seven databases were searched from inception to June 2013. Hand searching of included studies references was also conducted. Studies comparing the effects of patient initiated clinics with traditional consultant led clinics in secondary care for patients with long term chronic or recurrent diseases on health related quality of life and/or patient satisfaction were included. Data was extracted by one reviewer and checked by a second. Results were synthesised narratively. Results Seven studies were included in the review, these covered a total of 1,655 participants across three conditions: breast cancer, inflammatory bowel disease and rheumatoid arthritis. Quality of reporting was variable. Results showed no significant differences between the intervention and control groups for psychological and health related quality of life outcomes indicating no evidence of harm. Some patients reported significantly more satisfaction using patient-initiated clinics than usual care (p Conclusions The results show potential for patient initiated clinics to result in greater patient and clinician satisfaction. The patient-consultant relationship appeared to play an important part in patient satisfaction and should be considered an important area of future research as should the presence or absence of a guidebook to aid self-management. Patient initiated clinics fit the models of care suggested by policy makers and so further research into long term outcomes for patients and service use in this area of practice is both relevant and timely.
机译：背景错过或不适当的医院预约会给NHS带来巨大的损失。预约安排的替代方法可能会更灵活地适应患者的需求，而不会危害健康和服务质量。目的是系统地审查慢性/复发性疾病患者中患者报告的结局的患者在二级医疗机构中开设诊所的证据。方法从开始到2013年6月，共检索了7个数据库。包括将患者创办的诊所与传统的顾问领导的诊所在二级医疗中对长期慢性或复发性疾病患者的健康相关生活质量和/或患者满意度的影响进行比较的研究。数据由一名审阅者提取，并由另一名审阅。结果是叙述性的。结果该评价包括七项研究，这些研究共涵盖1,655名受试者，涉及三种疾病：乳腺癌，炎性肠病和类风湿关节炎。报告的质量是可变的。结果显示，干预组和对照组在心理和健康相关生活质量方面无显着差异，表明没有伤害证据。一些患者报告说，与普通护理相比，患者开办的诊所满意度更高（p结论结论表明，患者开办诊所有可能提高患者和临床医生的满意度。患者与顾问的关系似乎在患者满意度中起着重要作用，应该患者指导的诊所符合政策制定者建议的护理模式，因此被认为是未来研究的重要领域，而是否存在指导自我管理的指南也应如此，因此在此方面应进一步研究患者的长期结果和服务使用实践领域既相关又及时。

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