统一门诊实践以纠正城市卫生系统中的结构性种族主义
Sofia R Schlozman1, Margaret Smirnoff2, Ann Scheck McAlearney3
1UCSF School of Medicine, University of California, San Francisco.
JAMA health forum
|February 21, 2025
概括
医疗保健中的实践统一旨在通过整合隔离的诊所来减少结构性种族主义. 虽然被认为是财务和股权驱动的,但成功实施需要解决财务,空间和满意度的挑战.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 医疗保健中的结构性种族主义
背景情况:
- 医疗保健中的结构性种族主义通过基于种族和保险类型的分离临床护理场所继续存在.
- 实践统一是一种新兴的战略,旨在消除这种隔离,促进公平.
研究的目的:
- 在一个大型城市卫生系统中调查门诊实践统一的促进者,障碍和影响.
- 制定一个成功实践统一的框架,以减少结构性种族主义.
主要方法:
- 使用与临床,行政和卫生系统领导人的半结构面试进行定性研究.
- 在纽约的一个大型城市卫生系统中进行 (2023年2月至10月).
- 专题分析以确定与统一有关的关键主题.
主要成果:
- 促进者包括财务利益,新设施和领导力倡导;障碍包括财务问题,空间和员工态度.
- 统一后的好处:财务收益,增加了支持人员,感知了公平,提高了满意度.
- 挑战:员工角色的变化,财务问题,患者的不满以及持续的隔离维度 (医生,付款人,时间).
结论:
- 门诊实践统一被视为一个由财务和股权驱动的过程.
- 成功的统一需要解决财务,空间,报销和满意度的挑战.
- 关注多个维度对于有效实施和克服持续的隔离至关重要.
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