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首页> 外文期刊>International journal of health care quality assurance >Comparing and improving chronic illness primary care in Sweden and the USA
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Comparing and improving chronic illness primary care in Sweden and the USA

机译：在瑞典和美国比较和改善慢性病初级保健

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Purpose - The purpose of this paper is to identify opportunities for improving primary care services for people with chronic illnesses by comparing how Sweden and US services use evidence-based practices (EBPs), including digital health technologies (DHTs). Design/methodology/approach - A national primary healthcare center (PHCC) heads surveys in 2012-2013 carried out in both countries in 2006. Findings - There are large variations between the two countries. The largest, regarding effective DHT use in primary care centers, were that few Swedish primary healthcare compared to US heads reported having reminders or prompts at the point of care (38 percent Sweden vs 84 percent USA), despite Sweden's established electronic medical records (EMR). Swedish heads also reported 30 percent fewer centers receiving laboratory results (67 percent Sweden vs 97 percent USA). Regarding following other EBPs, 70 percent of Swedish center heads reported their physicians had easy access to diabetic patient lists compared to 14 percent in the USA. Most Swedish PHCC heads (96 percent) said they offered same day appointment compared to 36 percent in equivalent US practices. Practical implications - There are opportunities for improvement based on significant differences in effective practices between the countries, which demonstrates to primary care leaders that their peers elsewhere potentially provide better care for people with chronic illnesses. Some improvements are under primary care center control and can be made quickly. There is evidence that people with chronic illnesses in these two countries are suffering unnecessarily owing to primary care staff failing to provide proven EBP, which would better meet patient needs. Public finance has been invested in DHT, which are not being used to their full potential. Originality/value - The study shows the gaps between current and potential proven effective EBPs for services to patients with chronic conditions. Findings suggest possible explanations for differences and practical improvements by comparing the two countries. Many enhancements are low cost and the proportionate reduction in suffering and costs they bring is high.
机译：目的-本文的目的是通过比较瑞典和美国的服务如何使用包括数字医疗技术（DHT）在内的循证实践（EBP）来确定改善慢性病患者初级保健服务的机会。设计/方法/方法-2006年，两国在2012-2013年间进行了全国初级卫生保健中心（PHCC）的调查。调查结果-两国之间存在很大差异。关于在初级保健中心有效使用DHT的最大问题是，尽管瑞典已经建立了电子病历（EMR），但与美国负责人说在医疗点具有提醒或提示的瑞典初级保健很少（38％的瑞典对84％的美国）。 ）。瑞典负责人还报告说，接受实验室检查结果的中心减少了30％（瑞典为67％，美国为97％）。关于其他EBP，瑞典70％的中心负责人表示，他们的医生很容易获得糖尿病患者名单，而美国为14％。瑞典大多数PHCC负责人（96％）表示，他们提供当日约会，而美国同等做法中只有36％。实际意义-各国之间在有效实践上存在显着差异，因此有改善的机会，这向初级保健负责人表明，他们在其他地方的同龄人有可能为慢性病患者提供更好的护理。一些改善措施由初级保健中心控制，可以迅速进行。有证据表明，这两个国家的慢性病患者不必要地遭受痛苦，因为初级保健人员未能提供经过证实的EBP，而EBP可以更好地满足患者的需求。公共财政已投资于DHT，尚未充分发挥其潜力。原创性/价值-研究表明，当前和潜在的有效EBP在为慢性病患者提供服务方面存在差距。通过比较两国，发现为差异和实际改进提供了可能的解释。许多改进是低成本的，并且相应减少痛苦和带来的成本很高。

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