tailieunhanh - báo cáo khoa học: "Patient Care Teams in treatment of diabetes and chronic heart failure in primary care: an observational networks study"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Patient Care Teams in treatment of diabetes and chronic heart failure in primary care: an observational networks study | Weenink et al. Implementation Science 2011 6 66 http content 6 1 66 Implementation Science IMPLEMENTATION SCIENCE RESEARCH Open Access Patient Care Teams in treatment of diabetes and chronic heart failure in primary care an observational networks study Jan-Willem Weenink Jan van Lieshout Hans Peter Jung and Michel Wensing Abstract Background Patient care teams have an important role in providing medical care to patients with chronic disease but insight into how to improve their performance is limited. Two potentially relevant determinants are the presence of a central care provider with a coordinating role and an active role of the patient in the network of care providers. In this study we aimed to develop and test measures of these factors related to the network of care providers of an individual patient. Methods We performed an observational study in patients with type 2 diabetes or chronic heart failure who were recruited from three primary care practices in The Netherlands. The study focused on medical treatment advice on physical activity and disease monitoring. We used patient questionnaires and chart review to measure connections between the patient and care providers and a written survey among care providers to measure their connections. Data on clinical performance were extracted from the medical records. We used network analysis to compute degree centrality coefficients for the patient and to identify the most central health professional in each network. A range of other network characteristics were computed including network centralization density size diversity of disciplines and overlap among activity-specific networks. Differences across the two chronic conditions and associations with disease monitoring were explored. Results Approximately 50 of the invited patients participated. Participation rates of health professionals were close to 100 . We identified 63 networks of 25 patients 22 for medical treatment 16 for .