一个悖论的问题在访问一般实践:一个定性参与的案例研究
Jennifer Voorhees1, Simon Bailey2, Heather Waterman3
1Centre for Primary Care and Health Services Research, University of Manchester, Manchester.
概括
获得通用实践是复杂的,需求创造了未满足的需求和不平等. 了解这种悖论可以帮助改善护理提供和患者获得服务的机会.
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
- 卫生社会学 卫生社会学
背景情况:
- 长期存在的通用实践访问问题仍然存在.
- 现有的方法往往忽视了用户和提供者的观点.
- 已建立的访问理论在理解复杂性方面未得到充分利用.
研究的目的:
- 从用户和工作人员的角度探讨一般实践的访问障碍.
- 应用已建立的访问理论来分析复杂性.
- 为了获得对初级保健准入的多视角理解.
主要方法:
- 在英格兰西北部进行的定性参与案例研究.
- 基于社区的参与式方法,包括采访,焦点小组和观察.
- 诱导和诱导分析由Levesque等人提供. 这是访问的理论.
主要成果:
- 存在一种悖论,即对通用实践的需求既创造又掩盖了未满足的需求.
- 响应性规则来管理需求已经侵蚀了护理连续性.
- 复杂的规则和有限的容量阻碍了患者的导航,加剧了健康不平等.
结论:
- 承认访问悖论为干预提供了新的干预目标.
- 可以开发解决方案,以增加一般实践能力.
- 解决未得到满足的需求和改善接入,可以减少健康不平等.
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