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首页> 外文期刊>Journal of Clinical Medicine Research >Does Open Access Improve the Process and Outcome of Podiatric Care?
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Does Open Access Improve the Process and Outcome of Podiatric Care?

机译：开放获取会改善儿科护理的过程和结果吗？

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Background: Open access to clinics is a management strategy to improve healthcare delivery. Providers are sometimes hesitant to adopt open access because of fear of increased visits for potentially trivial complaints. We hypothesized open access clinics would result in decreased wait times, increased number of podiatry visits, fewer “no shows,” higher rates of acute care visits, and lower minor amputation rates over control clinics without open access.Methods: This study was a national retrospective case-control study of VHA (Veterans Hospital Administration) podiatry clinics in 2008. Eight case facilities reported to have open podiatry clinic access for at least one year were identified from an email survey. Sixteen control facilities with similar structural features (e.g., full time podiatrists, health tech, residency program, reconstructive foot surgery, vascular, and orthopedic surgery) were identified in the same geographic region as the case facilities.Results: Twenty-two percent of facilities responded to the survey. Fifty-four percent reported open access and 46% did not. There were no differences in facility or podiatry panel size, podiatry visits, or visit frequency between the cases and controls. Podiatry visits trended higher for control facilities but didn’t reach statistical significance. Case facilities had more new consults seen within 30 days (96%, 89%; P = 0.050) and lower minor amputation rates (0.62/1,000, 1.0/1,000; P = 0.041).Conclusions: The VHA is the world’s largest managed care organization and it relies on clinical efficiencies as one mechanism to improve the quality of care. Open access clinics had more timely access for new patients and lower rates of minor amputations.?doi:10.4021/jocmr545w
机译：背景：对诊所的开放访问是一种改善医疗保健服务的管理策略。提供者有时会犹豫采用开放获取，因为担心增加访问量以应对潜在的琐碎投诉。我们假设，与没有开放通道的对照诊所相比，开放通道诊所将导致等待时间减少，足病诊治次数增加，“未显示”次数减少，急性护理就诊率更高，较小的截肢率。方法：本研究是全国性的在2008年对VHA（退伍军人医院管理局）足病诊所进行了病例回顾性研究。通过电子邮件调查确定了8个据报有足病诊所开放至少一年的病例。在与案例设施相同的地理区域中，确定了十六个具有相似结构特征的控制设施（例如，专职脚病医生，卫生技术，住院医师计划，足部整形外科手术，血管和骨科手术）。结果：百分之二十二的设施回应了调查。有54％的人表示开放访问，而46％的人没有开放访问。在病例和对照之间，设施或足病小组的大小，足病访视或访视频率没有差异。控制设施的足病诊疗趋势呈上升趋势，但未达到统计意义。案例机构在30天内看到更多新咨询人（96％，89％; P = 0.050）和较低的轻度截肢率（0.62 / 1,000，1.0 / 1,000; P = 0.041）。结论：VHA是世界上最大的管理式护理组织，它依靠临床效率作为提高护理质量的一种机制。开放式诊所为新患者提供了更及时的准入机会，并降低了较小的截肢率。doi：10.4021 / jocmr545w

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