美国初级保健实践能力与英语能力有限的患者的语言服务相关
Stacy Chen1, Jenny S Guadamuz2, Hector P Rodriguez2
1Division of Health Policy and Management, School of Public Health, University of California, Berkeley, USA. stacy_chen@berkeley.edu.
Journal of general internal medicine
|December 1, 2025
概括
几乎一半的美国初级保健实践不总是为英语水平有限的患者提供语言服务 (LEP),尽管法律要求. 实践所有权和付款人的混合方式显著影响服务的可用性.
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
- 初级医疗保健医学 一级医疗保健医学
背景情况:
- 具有有限英语水平 (LEP) 的患者在医疗保健环境中面临重大沟通障碍.
- 联邦政策要求提供语言服务,但国家关于其在初级保健中的可用性数据很少.
研究的目的:
- 确定与LEP患者语言服务的持续可用性相关的初级保健医生实践的特征.
- 了解影响成人初级保健中语言服务常规提供因素.
主要方法:
- 利用了与IQVIA OneKey和美国社区调查相关的全国代表性调查数据 (国家医疗保健组织和系统调查).
- 采用多变量逻辑回归来分析实践属性与语言服务可用性之间的关联.
- 定义"总是"提供专业的语言服务作为可用性的首要指标.
主要成果:
- 在美国,有54%的初级保健机构始终提供语言服务.
- 负责护理组织 (ACO) 的实践,由医疗保健系统/医院拥有,或具有联邦合格健康中心 (FQHC) 状态,更有可能提供服务.
- 医疗补助收入较高的实践显示增加了可能性,而商业保险收入较高的实践则不太可能提供语言服务.
结论:
- 很大一部分初级保健实践未能持续为LEP患者提供强制性语言服务.
- 实践所有权 (系统附属与独立) 和FQHC状态是语言服务可用性的关键因素.
- 支持ACO参与的政策干预和有利的医疗补助支付者组合可以增强例行语言服务提供.
相关概念视频
01:15Methods of Documentation VI: Case Management Model
839
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
839
01:30Specialized Care Centers and Settings-II
1.2K
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
1.2K
01:13Patient-centered Care
2.8K
Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
2.8K
01:30Specialized Care Centers and Settings-I
1.4K
Specialized care settings or centers are situated in convenient locations within the community and offer care to a specific group or population. They consist of daycare facilities, mental health facilities, rural health facilities, educational institutions, industries, shelters for the homeless, and rehabilitation facilities.
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
1.4K
01:21Interdisciplinary Care: The Health Care Team-I
2.5K
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
2.5K
01:21Barriers to Effective Communication II
4.5K
The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
4.5K