在连接到资源以解决社会需求的次人口差异.
Deborah A Gurewich1, Hannah Friedman2, Mingfei Li3
1Center for Healthcare Optimization and Implementation Research (CHOIR), VA Boston Healthcare System, 150 South Huntington Avenue, Boston, MA 02130; Section of General Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, 02118.
American journal of preventive medicine
|December 3, 2025
概括
连接退伍军人与社会需求资源的医疗保健干预措施显示,特定的子组受益最多. 社会工作者导航显著改善了低收入和高共患病率退伍军人的资源连接.
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
- 退伍军人事务 医疗保健 医疗保健
背景情况:
- 解决社会需求的医疗保健干预措施正在增加.
- 很少有研究确定了从这些干预中获益最多的特定子群体.
- 了解差异性有效性对于优化资源配置和改善结果至关重要.
研究的目的:
- 评估基于医疗保健的社会需求干预措施在不同退伍军人亚群的比较有效性.
- 确定哪些退伍军人的社会人口和临床特征与差异性干预成功有关.
主要方法:
- 一个三臂随机对照试验 (RCT),比较一个对照组 (通用资源) 和两个干预臂 (量身定制的资源,量身定制的资源加上社会工作者导航).
- 使用随机效应的通用线性模型进行了临时子组分析.
- 分析基于退伍军人的社会人口统计学和临床因素,包括收入和并发症数量来检查结果.
主要成果:
- 退伍军人谁是低收入和不符合VA残疾福利,以及那些有四个或更多的埃利克沙瑟并发症的退伍军人,显示显著更高的几率连接到社会资源,当接受社会工作者导航 (手臂3对社会工作者导航). 一个手臂 一个手臂.
- 在第三臂与第一臂资源连接的几率比率为6.47 (CI [1.8722.37]) 和2.18 (CI [1.164.10]) 对于这些分组.
- 被处理的分析也支持了社会工作者导航组件的有效性.
结论:
- 特定的退伍军人小组,特别是那些低收入和高并发症负担的人,可能会从加强的社会需求干预中获得最大的好处.
- 未来的研究应该旨在证实这些发现,并探索它们在不同退伍军人群体中的通用性.
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