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一个学术直接的初级保健诊所如何为来自弱势社区的患者提供服务
Winston Liaw1, Ben King2, Henry Olaisen2
1From the Department of Health Systems and Population Health Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX (WL, BK); Agency for Healthcare Research and Quality, Rockville, MD; American Academy of Family Physicians, Washington, DC (HO); Elation Health, San Antonio, TX (SP); Texas Water Development Board (AK); Elation Health, Houston, TX (NC); Department of Clinical Sciences, University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX (BR); Suvida Healthcare, Houston, TX (OMV); American Academy of Family Physicians, Overland Park, KS (SW); University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX (SS). winstonrliaw@gmail.com).
直接初级保健 (DPC) 诊所可以为弱势群体提供服务,正如一个学术 DPC 诊所所所示,该诊所照顾高脆弱性人口普查区域的患者. 这与DPC模型只吸引富裕患者的观念相抵触.
科学领域:
- 获得医疗保健的机会.
- 初级保健模式的初级保健模型.
- 卫生公平性健康公平性
背景情况:
- 直接初级保健 (DPC) 是一种定期收费的医疗保健模式.
- 批评人士表示担心,这种费用结构可能会排除弱势群体.
- 了解DPC患者的人口统计数据对于评估其可访问性至关重要.
研究的目的:
- 描述现在已关闭的学术DPC诊所患者的人口统计和预约模式.
- 为了比较人口普查区的社会脆弱性指数 (SVI) 与DPC患者和没有DPC患者.
主要方法:
- 将电子健康记录数据与社会脆弱性指数 (SVI) 联系起来.
- 描述了患者的人口统计 (年龄,性别,语言,诊断) 和预约频率.
- 使用t测试和曼·惠特尼U测试来比较SVI和人口普查变量与临床患者和没有临床患者之间的路径.
主要成果:
- 该研究包括322名患者和772个预约;大多数患者是女性,超过三分之一的人说西班牙语.
- 患者平均被看了2.4次,平均每位患者的诊断为3.68次.
- 与没有DPC患者的人口普查区域相比,拥有DPC患者的人口普查区域的SVI得分显著更高 (表明更大的脆弱性) (中位数为0.60对0.47,p <0.05).
结论:
- 学术DPC诊所为居住在脆弱人口普查地区的个人提供服务.
- 这一发现挑战了人们对DPC诊所主要服务于富裕人口的看法.
- 尽管由于障碍而关闭,但该诊所证明了DPC有潜力接触到服务不足的社区.
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