集中边缘化护理:家庭护理合作社和系统变革
Geoffrey M Gusoff1, Lina Stepick2, Aquilina Soriano-Versoza3
1Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
家庭护理工作者 (HCW) 面临着系统性边缘化,导致贫困和劳动力短缺. 家庭护理合作社赋予医疗保健工作者权力,改善护理连续性和减少营业额,展示了更公平的基本护理工作模式.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 劳动经济学 劳动经济学
- 劳动社会学工作的社会学.
背景情况:
- 家庭护理工作者 (HCW) 对数百万需要日常支持的人来说至关重要.
- 目前的制度降低了护理工作的价值,不成比例地影响了女性,移民和有色人种的劳动力.
- 医疗保健职工的系统边缘化导致贫困和严重的劳动力短缺,影响获得护理的机会.
研究的目的:
- 检查家庭护理工作者 (HCWs) 的系统性边缘化.
- 探索家庭护理合作社作为HCW就业和护理服务的替代模式.
- 确定必要的系统变化,以集中HCW并提高护理质量.
主要方法:
- 对政治经济体系对高压工厂的影响进行定性分析.
- 家庭护理合作社与传统机构的比较分析.
- 确定系统变化所需的政策和叙事转变.
主要成果:
- 家庭护理合作社为HCW提供更好的补偿,培训和工作场所控制.
- 合作社比传统机构获得更高的护理连续性和明显较低的营业额 (50%以下).
- 在组织层面集中医疗保健工作者表明了医疗保健提供系统性改进的潜力.
结论:
- 家庭护理合作社为赋予HCW和提高护理质量提供了可行的模式.
- 系统性变革需要将护理工作视为公共利益,并对此进行投资.
- 在结构上赋予HCW权力,并重构叙述,对于一个公正有效的护理系统至关重要.
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