整合付款人分离的门诊妇科医生护理模式:临床医生的观点
Arina Chesnokova1, Allison Schachter2, Elizabeth Clement1
1Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
概括
临床医生支持整合隔离的门诊护理,以解决母亲健康方面的种族差异,尽管人们对可行性的担忧. 在全面实施之前,需要进一步的研究和试点计划.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 学术医学 学术医学
背景情况:
- 在美国,母亲和妇科健康结果的种族差异是显著的.
- 门诊护理环境可能会导致这些差异.
- 学术医疗中心通常会根据保险支付人进行隔离护理,从而导致事实上的种族隔离.
研究的目的:
- 探索临床医生对付款人分离的门诊护理的观点.
- 评估临床医生关于整合住院医生和主治医生的意见.
- 确定在学术医疗中心的护理整合的障碍和促进者.
主要方法:
- 与临床医生和高级实践提供者 (APP) 进行了半结构化采访.
- 采访的重点是当前模式的感知价值,对整合的态度,以及障碍/促进者.
- 数据分析使用了接地理论,具有编码器间可靠性 (k = .90).
主要成果:
- 临床医生认识到隔离系统的某些价值,但支持将整合视为道德上的必要.
- 担忧包括患者-临床医生连续性,实习生接受,使命驱动的护理侵蚀,以及潜在的种族主义互动.
- 临床医生强调,在完全整合之前,需要资源和小规模试验.
结论:
- 临床医生在整合门诊护理方面一致,但实施途径尚不清楚.
- 这项研究提供了关于门诊产科医生护理差异的见解.
- 调查结果可以指导卫生系统考虑护理整合,以提高公平性.
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