临床医生和工作人员对健康计划实施的社会驱动因素的看法
Stacie M Vilendrer1, Samuel C Thomas2, Kim Brunisholz
1From the Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA (SMV, GAK, NS, SJS); Healthcare Delivery Institute, Intermountain Health, Murray, UT (SCT, IS, RS); Department of Health Policy, Stanford University School of Medicine, Stanford, CA (SJS). staciev@stanford.edu.
Journal of the American Board of Family Medicine : JABFM
|March 21, 2025
概括
在初级保健中实施健康的普遍社会驱动因素 (SDOH) 查面临挑战. 障碍包括员工的时间和服务的可用性,这表明有针对性的方法可能更可行.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 健康的社会决定因素
背景情况:
- 卫生系统越来越多地对健康的社会驱动因素 (SDOH) 进行查,以解决健康不平等问题.
- 一个大型综合卫生系统在2019年实施了通用SDOH查计划.
研究的目的:
- 探索一线临床医生和工作人员对普遍SDOH查计划可行性,工作流程和实施的态度.
- 确定在初级保健机构中成功实施SDOH计划的促进者和障碍.
主要方法:
- 半结构面试与20名前线临床医生和五个不同的初级保健诊所的员工进行了面试.
- 使用诱导导分析来确定SDOH计划实施的关键主题和最佳实践.
主要成果:
- 进行了超过16000次SDOH查,查率因诊所而异.
- 关键的障碍包括员工的时间限制,有限的社会服务可用性和员工士气的下降.
- 促进者包括建立的分拣协议,标准化的数字访问前查,并通过教育和团队聚集来促进共享所有权.
结论:
- 在初级保健中,普遍的SDOH查可能由于时间限制和服务可用性而不可行.
- 未来的研究应该调查有针对性的查方法和SDOH计划和其他临床优先事项之间的权衡.
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