评估社会护理倡议的公平实施,整合医疗和社会服务,为医疗补助计划成员提供医疗和社会服务
Nadia Safaeinili1, Emmeline Chuang2, Elizabeth Hernandez3
1School of Medicine, Stanford University, Palo Alto, California, USA.
Health services research
|March 20, 2025
概括
综合医疗和社会服务案例管理的公平实施需要解决患者虐待和系统性障碍. 投资于多元化的团队,强有力的领导力和组织准备对于服务于边缘化的医疗补助计划成员至关重要.
科学领域:
- 实施科学 实施科学
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 结合医疗和社会服务的综合护理模式旨在改善弱势群体的结果.
- 公平的实施至关重要,以确保这些计划有利于所有成员,特别是那些历史上被边缘化的人.
- 医疗补助计划成员经常面临复杂的健康社会决定因素,需要协调服务提供.
研究的目的:
- 评估一个整合医疗和社会服务的病例管理计划对Medicaid会员的公平实施.
- 在这个综合护理模式中,确定促进公平实施的促进者和障碍.
- 为未来的项目开发和政策提供信息,以提供公平的服务.
主要方法:
- 使用半结构面试对患者,病例经理和县行政人员进行定性研究.
- 有目的的抽样,以确定关键告密者.
- 根据卫生公平实施框架 (HEIF) 的信息,进行了感应-减去框架分析.
主要成果:
- 关键的创新因素包括强大的领导力和社会风险因素算法. 受理因素包括对不同病例管理团队的不公平的情感要求和对患者的虐待.
- 临床接触突出了对信任和多学科专业知识的需求. 背景因素透露了通过多学科团队和数据基础设施的组织准备.
- 社会因素,如系统歧视,住房/过境问题和行政障碍,对实施产生了重大影响.
结论:
- 公平的综合护理计划需要投资于多学科团队和经验丰富的领导力.
- 组织准备,包括强大的数据基础设施和伙伴关系,对于公平实施至关重要.
- 干预措施必须解决歧视和行政障碍等系统因素,以有效地参与边缘化群体.
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