生活在社会弱势群体中的患者经历了以团队为基础的初级医疗保健诊所的减少
Nadia Deville-Stoetzel1, Isabelle Gaboury2, Jeannie Haggerty3
1Postdoctoral Fellow, Department of Community Health Sciences, Université de Sherbrooke, Longueuil, QC.
Healthcare policy = Politiques de sante
|July 24, 2023
概括
患有社会脆弱性的患者面临更大的挑战,获得以团队为基础的初级医疗保健,遇到护理和沟通连续性的问题. 了解这些差异对于改善所有人口获得医疗保健的机会至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 主要护理医学 医疗保健
- 健康的社会决定因素
背景情况:
- 基于团队的初级医疗保健模式旨在改善医疗保健的提供.
- 社会脆弱性越来越被认为是影响健康结果和获得护理的关键因素.
- 在获得医疗保健方面的差异仍然存在,特别是在弱势群体中.
研究的目的:
- 调查社会脆弱性如何影响患者在以团队为基础的初级医疗保健机构获得护理的经验.
- 确定与不同程度的社会脆弱性相关的具体护理障碍.
主要方法:
- 在四个以团队为基础的初级医疗保健诊所对1562名患者进行了横截面电子调查.
- 社会脆弱性指数被用来对患者进行分类,并比较他们报告的与获得医疗保健的经历.
- 数据是在2021年6月至11月期间收集的.
主要成果:
- 与没有社会脆弱性的患者相比,由于医生不可用,社会脆弱性较低的患者报告了更高的急诊室利用率 (p = 0.006).
- 在弱势群体中,缺乏护理连续性更为普遍,理由是团队成员对病史不熟悉,文件责任不清楚.
- 低脆弱性和高脆弱性组都报告说,他们比非脆弱的患者更频繁地收到相互矛盾的信息.
结论:
- 具有高度社会脆弱性的患者会遇到严重的接入障碍,特别是关于护理的连续性,专业间的合作和提供者沟通.
- 研究结果强调,需要在以团队为基础的初级保健中采取有针对性的干预措施,以解决社会脆弱患者的独特需求.
- 解决社会脆弱性对于实现平等获得初级医疗保健服务至关重要.
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