在社会弱势社区的行为健康劳动力分布
Brianna Lombardi1,2,3, Lisa de Saxe Zerden4,5, Todd Jensen4,5
1School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB #3550, Chapel Hill, NC, 27599-3550, USA. Brianna_lombardi@med.unc.edu.
The journal of behavioral health services & research
|July 26, 2024
概括
在高度不利的地区,行为健康临床医生 (BHC) 不太常见. 这种分配不当凸显了弱势群体获得护理的差异,需要进行政策改革,以实现公平的安置.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医学地理 医学地理
- 健康 公平 卫生 公平
背景情况:
- 处境不利的社区在获得行为健康护理方面面临重大障碍.
- 了解行为健康临床医生 (BHC) 的地理分布对于解决这些差异至关重要.
研究的目的:
- 分析三个BHC类型 (辅导员,社会工作者,心理学家) 与美国地区不利关系的地理分布.
- 确定影响高需求与低需求地区BHC度的因素.
主要方法:
- 利用CMS国家计划和提供商计数系统的数据来识别BHC实践地址.
- 地理编码地址并将它们映射到人口普查区组,按区域不利指数 (ADI) 分层分层.
- 采用零膨胀负二项式模型来评估每10万人口的ADI,农村和BHC数量之间的关联.
主要成果:
- 人均BHC数量较少的地区处于较高的劣势 (100万人口中最需要的地区为267人,最不需要的地区为351人).
- 根据ADI和农村地区,BHC类型的分布有很大差异.
- 处境不利的农村地区的BHC度最低.
结论:
- 该研究揭示了BHCs的分布不良,在高度不利的地区的临床医生较少.
- 在高需求地区对行为健康工作人员的公平定位对于增加获得护理的机会至关重要.
- 政策和支付改革可能会激励BHC在社会不利的社区进行实践.
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