在新墨西哥州实施全面的成恢复法案 (CARA) 政策的实施评估
Nicholas Sharp1, Jessi Fuchs2, Amy Drake2
1New Mexico Department of Health, 2040 S. Pacheco, Santa Fe, NM, USA. Nicholas.Sharp@doh.nm.gov.
Maternal and child health journal
|October 18, 2023
概括
在新墨西哥州实施全面的成和康复法案 (CARA) 政策面临挑战. 家庭不一致地参与了护理计划,有限的资源和提供者偏见阻碍了对患有物质使用障碍的孕妇有效支持.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 药物使用障碍 药物使用障碍
背景情况:
- 综合性成和康复法 (CARA) 旨在为患有物质使用障碍的孕妇提供支持性护理.
- 新墨西哥州的CARA实施重点是为受影响的家庭和新生儿提供非惩罚性护理和服务协调.
研究的目的:
- 评估新墨西哥州CARA政策实施的忠实性.
- 识别对有效的CARA计划交付的障碍和促进者.
主要方法:
- 利用了计划报告,家庭后续调查,安全护理数据库计划和医疗补助索赔数据链接.
- 检查了家庭参与护理计划的制定和信息的接收.
- 通过Medicaid数据评估CARA参与率与医疗保健利用率之间的相关性.
主要成果:
- 家庭参与制定或接受安全护理计划是不一致的.
- 家庭发现分娩后的直接时期对于讨论护理计划具有挑战性.
- 显著比例的婴儿暴露于子宫内物质 (40.3%) 没有获得安全护理计划.
- 资源有限和供应商偏见被确定为实施障碍.
结论:
- 实施CARA的障碍包括资金,系统容量,缺乏普遍查,访问差异和提供者偏见.
- 建议包括普遍的产前物质使用查,加强反偏见培训,增加医院支持和改进数据管理.
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