在初级保健中提供的性取向和性别认同肯定活动
Ellesse-Roselee L Akre1, Ching-Wen Wendy Yang2, Greta R Bauer3
1Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
JAMA network open
|March 10, 2025
概括
参与性取向和性别认同 (SOGI) 肯定活动的初级保健实践更有可能成为联邦合格的卫生中心或为更高的医疗补助患者组合提供服务. 强制性培训和数据收集对于改善LGBTQ+医疗保健至关重要.
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
- 在LGBTQ+健康方面
背景情况:
- 解决女同性恋,男同性恋,双性恋,跨性别者和酷尔 (LGBTQ +) 社区的健康差异是一个关键的政策目标.
- 从有知识的临床医生那里获得安全,有尊重的初级医疗保健对于减少健康不平等至关重要.
研究的目的:
- 评估初级保健实践在多大程度上参与LGBTQ+肯定护理.
- 确定与更高参与LGBTQ+肯定护理活动相关的特定实践特征.
主要方法:
- 一项采用国家卫生保健组织和系统调查II (2022-2023) 的数据进行的横截面研究.
- 涉及美国初级保健实践中的初级保健医生和实践经理.
- 分析实践特征 (例如,FQHC状态,付款人组合,ACO参与,州LGBTQ+平等分数) 与支持SOGI的活动.
主要成果:
- 虽然许多实践机构收集了性取向和性别认同 (SOGI) 数据,但只有不到40%的实践机构提供了LGBTQ+培训.
- 联邦合格卫生中心 (FQHC) 指定,更高的医疗补助支付者组合和医疗补助ACO参与与增加的SOGI肯定活动有关.
- 较高的州LGBTQ+平等分数与更大的参与相关,而农村地区与肯定实践和推有负面关联.
结论:
- 在LGBTQ+肯定护理实践和初级保健中的培训中存在显著的差距.
- 需要政策干预,包括联邦/州对LGBTQ+医疗保健培训和标准化SOGI数据收集的授权.
- 这些措施对于农村地区来说尤其重要,以有效地减少LGBTQ+个体的健康差异.
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