远程协作专家小组部署以解决RICH LIFE项目中的健康差异
Lena Mathews1, Edgar R Miller, Lisa A Cooper
1Author Affiliations: Johns Hopkins Center for Health Equity (Drs Mathews, Miller, Cooper, Marsteller, Ndumele, Antoine, Carson, Ahima, Daumit, Oduwole, Onuoha, Brown, Dietz, Avornu, Chung and Crews), Welch Center for Epidemiology, Prevention, and Clinical Research (Drs Mathews, Miller, Cooper, Ndumele, Carson, Ahima, Daumit, and Crews), Department of Medicine (Drs Mathews, Miller, Cooper, Marsteller, Ndumele, Ahima, Daumit, and Crews), Department of Psychiatry and Behavioral Medicine (Dr Antoine), Department of Emergency Medicine, Johns Hopkins University School of Medicine (Dr Avornu), Baltimore, Maryland; Department of Epidemiology (Dr Cooper and Carson), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and University of California, San Francisco School of Medicine (Ms Onuoha), San Francisco, California.
一个远程协作专家小组显示,在服务不足的人群中,对管理高血压和并发性疾病的接受是有限但积极的. 修改可以加强其在解决医疗保健差异方面的作用.
科学领域:
- 健康差距 研究 研究 研究 研究
- 心血管医学 心血管医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 低收入和少数种族或少数民族的个人承担高血压和慢性疾病的高负担.
- 与社会上更有利的群体相比,这些人群往往只能获得有限的专业护理.
- 一个远程协作专家小组干预方案被开发出来,以解决综合护理中的这些差异.
研究的目的:
- 描述一个远程协作专家小组干预的部署.
- 评估干预的目标,即对患有高血压和并发性疾病的患者进行全面和协调的管理.
- 通过更好地获得专业专业知识来解决健康差异.
主要方法:
- 在"减少高血压护理中的不平等:改善每个人的生活方式" (RICH LIFE) 项目中使用了混合方法方法.
- 3个月后,患有控制不良的高血压或不受控制的并发病的参与者被转介给专家小组.
- 该小组由内科,心脏病学,病学,内分泌学和精神病学专家组成,远程讨论病例. 使用了RE-AIM框架.
主要成果:
- 只有6.3%的符合条件的参与者 (共302人中19人) 被转介给专家小组,主要是女性 (53%) 和黑人 (84%).
- 转诊原因包括失控的血压,糖尿病,慢性病和药物问题.
- 面板利用的障碍包括缺乏需求,繁的转介过程和远程性质;然而,转介护理经理们发现它很有价值.
结论:
- 远程协作专家小组干预的使用很少,但被转诊临床医生积极接受.
- 经过必要的修改,以提高采用率,该小组模型显示了解决高血压和多重疾病护理差异的潜力.
- 需要进一步的研究来优化这种远程专家干预的实施和影响.
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