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首页> 外文期刊>Journal of primary care & community health. >Use and Quality of Care at a VA Outreach Clinic in Northern Maine
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Use and Quality of Care at a VA Outreach Clinic in Northern Maine

机译：缅因州北部VA外联诊所的使用和护理质量

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Objective: To assess use and quality of care at a new I-day-per-week Veterans Administration Outreach Clinic in remote northern Maine. Methods: Veterans Administration electronic medical records were abstracted to compare outreach clinic patients seen in its first year to patients seen at the nearest outpatient treatment sites, a small-staff, full-time VA clinic 81 miles away and a community-based outpatient clinic 55 miles away. Chart abstractions (N = 1251) yielded counts of visits, patients newly enrolled inVA care, patients transferring to the outreach clinic, and patients who had and maintained a local non-VA primary care physician, as well as multiple quality of care performance measures using standard VA criteria. Results: The outreach clinic enrolled very few patients new to VA; 96% of its patients were transfers from other sites. For transfers, the average one-way driving burden to reach primary care was reduced by 52.9 miles and 58.1 minutes to reach. Compared to community-based outpatient clinic patients, outreach clinic patients were more likely to have three or more provider visits during the year. Some quality of care measures were lower at the outreach clinic: obesity screenings, referrals to smoking cessation services, diabetes management, and hypertension control.At all three sites, most patients had health insurance coverage and kept a local, non-VA doctor throughout the year. Conclusions: A part-time outreach clinic improved the convenience of primary care for rural VA outpatients, though quality of care was reduced for some measures related to equipment and staffing limitations. Most patients at any VA site had a local, non-VA medical doctor with whom they remained in care while using VA services.
机译：目的：评估位于缅因州北部偏远地区的新的每周I天“退伍军人管理局”外展诊所的使用情况和护理质量。方法：提取退伍军人管理局的电子病历，以比较第一年内就诊的门诊病人与最近的门诊就诊地点，81英里外的小型全职全职VA诊所和社区门诊55几英里以外。图表抽象（N = 1251）得出访问次数，新加入VA护理的患者，转移到外展诊所的患者以及曾经并维持过当地非VA初级保健医师的患者，以及使用标准VA标准。结果：外联诊所招收了很少的VA新患者。其96％的患者来自其他地点。对于接送服务，到达初级保健的平均单程驾驶负担减少了52.9英里和58.1分钟。与社区门诊患者相比，一年中门诊患者更有可能进行三次以上的医疗服务提供者就诊。外展诊所的一些护理措施质量较差：肥胖症筛查，转介戒烟服务，糖尿病管理和高血压控制。在这三个地点，大多数患者都有医疗保险，并在整个医疗过程中都聘请了当地的非弗吉尼亚州医生。年。结论：尽管有一些与设备和人员配备限制有关的措施降低了护理质量，但非全日制门诊诊所为农村VA门诊患者提高了初级护理的便利性。在任何VA站点上，大多数患者都有当地的非VA医生，他们在使用VA服务时一直受到护理。

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