一项混合方法研究,以了解社区卫生工作者与医疗保健团队的整合
Jessica McCutcheon1, Iris Cheng, Selina Quinones
1Author Affiliations: Department of Internal Medicine (Drs McCutcheon and Cheng, Ms Quinones, and Drs Denizard-Thompson, Wise Thomas, and Palakshappa), Department of Social Sciences Health Policy (Ms Wiseman), Department of Pediatrics (Dr Palakshappa), Department of Epidemiology and Prevention, Division of Public Health Sciences (Dr Palakshappa), Wake Forest University School of Medicine, Winston-Salem, North Carolina; and Center for Health System Sciences, Atrium Health, Charlotte, North Carolina (Drs McCutcheon, Cheng, Mahabaleshwarkar, and Taylor).
社区卫生工作者 (CHWs) 在医疗保健机构的整合显示出变化. 社区连接和雇佣的CHW都满足了各种需求,但在充分整合这些模式以获得更好的患者护理方面,仍然存在挑战.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 社区健康 社区健康
- 医疗保健管理的管理
背景情况:
- 社区卫生工作者 (CHW) 越来越多地融入医疗保健系统.
- 有两个主要的CHW整合模式:社区-临床联系和在医疗保健机构的直接就业.
- 了解这些模型的实现可变性对于优化其影响至关重要.
研究的目的:
- 调查社区卫生工作者整合模型实施的变异性.
- 确定社区临床联系和使用的CHW模型在实践中有何不同.
- 探索CHWs在这些不同的整合模式中的经验.
主要方法:
- 在一个大型卫生系统内进行了一项混合方法研究.
- 数据收集包括与医疗保健工作者 (N=29) 的重点小组和对转诊患者的电子健康记录数据的分析 (N=1,097).
- 从重点小组分析的定性主题与患者人口统计和医疗保健利用数据一起进行了定量分析.
主要成果:
- 从CHW重点小组中出现了三个主要的实施主题.
- 观察到,社区相关医疗保健工作者和雇佣医疗保健工作者转诊的患者的人口统计和医疗保健利用模式存在显著差异.
- 报告的两种模型的CHW解决了广泛的患者需求,表明功能重叠.
结论:
- 社区卫生工作者整合模式在实践中如何实施存在变化.
- 尽管解决了各种需求,但持续存在的挑战阻碍了社区链接和临床嵌入的CHW模型的充分整合.
- 需要进一步的研究和战略规划,以优化CHW的整合,以改善医疗保健服务.
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