以忠诚度扩大基于证据的社区卫生工作者计划:结果和经验教训
Molly Knowles1,2, Aditi Vasan3, Ziwei Pan4
1Division of General Internal Medicine, University of Pennsylvania Perelman School of Medicine, University of Pennsylvania.
The Milbank quarterly
|April 16, 2025
概括
社区卫生工作者 (CHW) 计划有效地解决了健康的社会决定因素. 实施IMPaCT模型证明了患者健康结果的持续改善,并在各种环境中减少了急性护理利用率.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 社区卫生工作者 (CHW) 计划对于解决健康的社会决定因素,改善患者的结果和降低成本至关重要.
- 诸如高周转率和基础设施不足等挑战阻碍了CHW计划的有效性和可扩展性.
- 以人为中心的目标个性化管理 (IMPaCT) 模型标准化了CHW流程,同时允许调整.
研究的目的:
- 评估IMPACT CHW模型在五个不同地点的实施和影响.
- 评估模型的忠实性,可持续性和对急性护理利用的影响.
主要方法:
- 通过在七个最佳实践领域的虚拟观察来评估模型忠实性.
- 使用急性护理评估使用差异回归与倾向性得分匹配.
- 这些措施包括总体住院日数,住院次数和急诊室访问次数.
主要成果:
- 核心IMPaCT计划组件在所有地点均一致实施.
- 五个站点中的三个站点在三年内持续实施.
- 观察到急性护理使用的显著减少,与之前的试验保持一致.
结论:
- 基于证据的CHW计划,如IMPACT,可以有效地实施,以解决健康的社会驱动因素.
- 实施中的忠实性是改善人口健康的关键,特别是对于低收入患者和有色人种患者.
相关概念视频
Levels of Health Promotion and Illness Prevention
12.7K
Health promotion allows a person to control the determinants of health, resulting in an improved health status. It enhances the quality of life and reduces premature deaths. Health promotion and illness prevention programs help people make beneficial choices to reduce the risk of disease and disabilities. There are three health promotion and illness prevention levels: primary, secondary, and tertiary prevention.
In primary prevention, actions taken before disease onset prevent the disease from...
In primary prevention, actions taken before disease onset prevent the disease from...
12.7K
Models of Health Promotion and Illness Prevention I
2.8K
A model is a theoretical way to understand a concept or an idea. Models can overcome barriers to health regardless of diverse economic and cultural backgrounds. In addition, models make the task easier by providing different ways to approach complex issues. There are two major health promotion models: the health belief model and the health promotion model.
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
2.8K
Models of Health Promotion and Illness Prevention II
2.1K
The person's health status fluctuates continually, varying from being in good health to becoming ill and returning to being healthy. To understand the concept of illness prevention, there are two models. First, the health-illness continuum model is a graphic representation of an individual's wellness. It states that a person is considered healthy in the absence of physical disease and the presence of good emotional health.
The agent-host-environment model states that disease results...
The agent-host-environment model states that disease results...
2.1K
Nursing Implementation
6.3K
Implementation is the execution of the nursing care plan developed during the planning phase.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
6.3K
Community Based Intervention
620
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
620
Scale-Up Processes
105
The scale-up of microbial fermentation processes is essential in industrial biotechnology, allowing the transition from laboratory-scale experiments to commercial-scale production while aiming to maintain product yield and quality. This process requires meticulous adjustment of equipment design, process parameters, and contamination control strategies to accommodate increasing culture volumes.At the laboratory scale, cultures are typically maintained in 1 to 10-liter glass or autoclavable...
105


