社区的社会经济特征与初级保健实践与执业护士
Monica O'Reilly-Jacob1, Kyle G Featherston1, Hilary Barnes2
1School of Nursing, Columbia University, New York, New York.
JAMA network open
|February 28, 2025
概括
执业护士 (NPs) 对于弱势社区的初级保健获得至关重要. 与NP的做法在低收入地区更为普遍,这表明它们在为弱势群体服务方面的作用.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康的社会经济决定因素
- 初级保健工作人员研究初级保健工作人员研究
背景情况:
- 获得初级保健的机会分布不均,特别是在社会经济不利的社区.
- 执业护士 (NP) 劳动力正在扩大,需要了解他们的实践分布.
- 评估与NP的初级保健实践的地理和社会经济分布对于健康公平至关重要.
研究的目的:
- 为了比较社区的社会经济特征,主办的初级保健实践与没有执业护士 (NP).
- 根据NP的存在和社区社会经济地位,确定初级保健实践分布的差异.
主要方法:
- 一项对79,743个初级保健实践的横截面分析,使用了来自IQVIA OneKey,美国人口普查,美国社区调查和区域贫困指数 (ADI) 的合并数据.
- 分析了社区的社会经济特征,包括收入,贫困水平,教育和ADI,跨越人口普查区和部门.
- 主要护理实践是根据执业护士 (NP) 的就业情况进行分类的.
主要成果:
- 超过一半 (53.4%) 的初级保健实践使用NP.
- 与NP相关的实践更有可能发生在低收入 (23.3%对17.0%) 和农村 (11.9%对5.5%) 社区.
- 与没有NP的社区相比,拥有NP人才实践的社区的贫困率更高,教育程度更低,平均ADI百分比更高 (53.3%与42.5%相比).
结论:
- 使用NP的初级保健实践不成比例地位于面临社会经济劣势的社区.
- 国家医疗机构在减轻缺乏服务和低收入人群获得初级保健的障碍方面发挥着至关重要的作用.
- 这些发现强调了NP在促进初级保健领域健康公平方面的重要性.
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