跨越2个社会卫生支持模式的医疗保健利用差异:随机试点评估结果
Ammarah Mahmud1,2, Edwin S Wong1,3, Cara C Lewis2
1Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington.
AJPM focus
|April 17, 2025
概括
当地,基于诊所的社区资源专家改善了初级保健,不仅仅是为有社会需求的患者提供呼叫中心. 这项社会卫生整合试点项目显示,随着个人支持,门诊利用率更好.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
- 整合初级保健的整合.
背景情况:
- 具有社会需求的患者往往面临着获得护理的障碍.
- 社会卫生整合计划旨在在医疗保健机构内解决这些需求.
- 试点项目对于评估护理提供新方法至关重要.
研究的目的:
- 为了比较基于诊所的社区资源专家和对有社会需求的患者的集中呼叫中心之间的利用结果.
- 评估不同社会支持模式对医疗保健利用的影响.
- 为制定有效的社会卫生整合战略提供信息.
主要方法:
- 随机对照试验涉及534名报告社会需求的参与者.
- 9个月的医疗保健利用结果的比较,包括初级保健,专科保健,急诊室和住院住院.
- 使用回归模型比较干预臂的治疗意图和治疗分析.
主要成果:
- 两种支持模型之间未经调整的利用结果没有显著差异.
- 调整后的分析表明,接受社区资源专家 (95%CI=0.336,1.746) 支持的参与者更高的初级保健接触.
- 随处理分析显示,社区资源专家支持的患者中,初级保健接触,专科护理接触和患者信息增加.
结论:
- 基于诊所的社会支持可以加强与护理团队的整合,以满足持续的患者需求.
- 当地,基于诊所的社区资源专家表明,与呼叫中心模型相比,门诊患者的利用率更高.
- 调查结果支持综合性,基于诊所的社会支持对改善医疗保健准入的有效性.
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