"这就像在迷宫中找到自己的路":对退伍军人获得医疗保健的经验进行了定性研究
NithyaPriya S Ramalingam1,2, Chrystal Barnes1,2, Mary Patzel3,4
1Oregon Rural Practice Based Research Network, Portland, USA.
Journal of general internal medicine
|October 31, 2023
概括
尽管有"使命法",但退伍军人面临着医疗保健接入障碍. 财务资源和VA系统知识可以减轻挫折,但复杂性和距离仍然是挑战,特别是对于农村退伍军人来说.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 退伍军人事务 医疗保健 医疗保健
- 健康 公平 卫生 公平
背景情况:
- 退伍军人选择法和使命法旨在改善退伍军人获得社区护理的机会.
- 农村退伍军人往往面临更长的距离到VA医疗设施.
研究的目的:
- 探索退伍军人与"使命法案"的经验.
- 了解对初级保健准入的影响,重点关注农村退伍军人.
主要方法:
- 使用半结构面试进行定性描述性设计.
- 美国西北各州退伍军人的有目的样本 (n=28).
- 面试成绩单的主题分析 (2020年8月至2021年9月).
主要成果:
- 52%使用社区护理;36%来自农村/边境地区.
- 退伍军人报告了积极的经验,但也对计费和事先授权感到丧.
- 医疗复杂性,距离和寻求女性医疗保健加剧了挫折感;财务资源和VA知识减轻了它们.
结论:
- 尽管有"使命法",但仍然存在医疗保健获取障碍.
- 患者的特征和系统导航的复杂性会影响访问.
- 需要对护理协调进行干预,以减少弱势退伍军人群体的不平等.
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