在医疗复杂的退伍军人中,社会风险与初级保健利用之间的关联
Mayuree Rao1,2,3, Liberty Greene4,5, Karin Nelson6,7,8
1Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA. mayuree.rao@va.gov.
Journal of general internal medicine
|June 27, 2023
概括
失业等社会风险与复杂患者较少使用初级保健相关. 社会工作未得到充分利用,这表明需要改善弱势群体获得这些重要服务的机会.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
- 主要护理医学 医疗保健
背景情况:
- 社会风险对健康状况产生重大影响,特别是对于患有复杂疾病的人来说.
- 这些社会风险也可能成为获得基本初级保健服务的障碍.
研究的目的:
- 研究各种社会风险与医疗复杂性患者使用初级保健服务之间的关系.
- 确定影响高风险退伍军人群体初级保健参与的特定社会因素.
主要方法:
- 一项前性队列研究使用10,000名退伍军人事务 (VA) 初级保健患者的全国代表样本进行,这些患者有住院或死亡的高风险.
- 数据是通过2018年邮寄调查收集的,评估了社会风险 (例如,失业,医疗素养低,社会支持低) 并与电子健康记录链接,用于2年内的利用结果.
- 结果包括初级保健提供者 (PCP) 接触,初级保健团队接触和社会工作利用.
主要成果:
- 在4680名受访者中,失业与PCP和初级保健团队接触较少有关.
- 低医疗素养与初级保健团队接触的增加有关.
- 总体而言,社会工作接触率很低 (18.4%),但更高的几率与医学素养低,交通问题和社会支持低有关.
结论:
- 在医学上复杂的VA患者中,初级护理和初级护理团队利用率基于社会风险显示出很小的差异.
- 尽管在应对社会风险方面具有重要意义,但社会工作服务的使用率显著低.
- 需要进一步的研究,以阐明阻碍这一群体更大程度地参与社会工作的障碍.
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