气管切除术儿童的公平照顾:应对挑战和寻求系统性解决方案
Jules Sherman1, Habib Zalzal2, Kyle Bower3
1Children's National Hospital, Innovation Ventures, Washington, DC, USA.
概括
患有医疗复杂性的儿童面临着重要的医疗保健接入障碍,包括保险和供应采购问题. 解决这些不平等问题需要改变政策,以改善这些弱势儿童的护理质量和健康结果.
科学领域:
- 儿科医疗保健 儿科医疗保健
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 患有医疗复杂性 (CMC) 的儿童在获得基本医疗设备,用品,家庭护理和社会服务方面遇到重大障碍.
- 这些接入挑战导致医疗保健不平等,影响后续护理,增加急诊室的使用,并可能导致不良事件.
- 解决这些系统性问题需要在州和联邦层面进行全面的政策改革.
研究的目的:
- 探索医疗保健专业人员和护理人员管理医疗复杂的儿童所面临的经验和系统性挑战,需要进行儿科气管切除术.
- 确定与医疗保健,保险和医疗用品采购相关的具体障碍.
主要方法:
- 采用了一种探索性的定性方法.
- 在美国,与17名卫生专业人员和初级护理人员进行了半结构化访谈.
- 用专题分析来分析转录的采访数据.
主要成果:
- 确定的主要挑战包括难以获得医疗保险和获得基本医疗用品的困难.
- 后勤限制和需要临时解决方案也是影响护理的重要问题.
- 在这些领域中确定了改进的机会.
结论:
- 社会生态因素对有医疗复杂性的儿童及其家属的健康和生活质量产生重大影响.
- 需要采取全面的方法来解决护理质量日益差距,考虑患者需求,监管框架和负担能力.
- 政策变化和改进的合作对于改善医疗保健提供和CMC的结果至关重要.
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