从统计数据到故事:理解错过医疗预约的复杂景观. 一个混合方法试点研究研究
Lea Charton1,2, Francis Gatier3, Chloe Delacour3
1General Medicine Department, Faculty of Medicine, University of Strasbourg, Strasbourg, France lea.charton@unistra.fr.
BJGP open
|May 2, 2024
概括
在法国,错过的全科医生预约与社会经济不稳定和社会隔离有关,特别是对于国家医疗保险的受益人来说. 解决这些社会决定因素对于改善医疗保健准入和减少健康不平等至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 卫生社会学 卫生社会学
背景情况:
- 错过的预约是初级保健中的一个重要问题,在英国和法国,5-10%的全科医生预约没有人出席.
- 研究将错过预约与增加短期死亡风险联系起来,需要对缺勤原因进行调查.
研究的目的:
- 调查城市卫生中心错过预约的根本原因.
- 探索健康的社会决定因素在预约缺席中的作用.
主要方法:
- 一种混合方法的方法,结合了定性电话采访和医疗记录的定量分析.
- 在法国一个城市卫生中心进行的研究,重点关注15天内错过预约的患者.
主要成果:
- 在53个错过的预约中,22名患者接受了采访. 国家医疗保险 (SHC) 的受益者将社会经济不稳定 (不稳定的工作,隔离,承诺) 列为主要原因.
- 非SHC受益者经常因忘记或自我解决健康问题而错过预约. 值得注意的是,36.4%的受访患者透露经历过家庭暴力.
- 超过四分之一的缺席预约被归类为"资本预约",表明缺席可能对患者健康造成重大伤害.
结论:
- 错过的预约可以作为社会不平等的指标,强调医疗保健系统需要适应患者的现实.
- 识别遭受暴力的患者,并将错过的预约作为后续电话的触发因素,是改善护理和减少健康差异的有希望的策略.
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