Randolph Greg D, Murray Mark, Swanson Jill A, Margolis Peter A
North Carolina Center for Children's Healthcare Improvement, Chapel Hill, North Carolina 27599-7226, USA.
Pediatrics. 2004 Mar;113(3 Pt 1):e230-7. doi: 10.1542/peds.113.3.e230.
Access to health care, the timely use of personal health services to achieve the best possible health outcomes, remains a fundamental problem for children in the United States. To date, research and interventions addressing children's access to care have largely focused on policy-level features of the health care system (such as health insurance and geographic availability of providers) with some, although limited, success. Ultimately, access to health care implies entry into the health care system. Practice scheduling systems are the point of entry to primary care health services for children and thus directly determine access to care in pediatric and family medicine practices. Here we explore the rationale for improving access to care for children from an additional angle: through improving practice scheduling systems. It is our hypothesis that some of the most promising contemporary interventions to improve children's access involve improving primary care scheduling systems. These approaches should complement successful policy-level interventions to improve access to care for children.
获得医疗保健服务，即及时利用个人健康服务以实现尽可能好的健康结果，仍然是美国儿童面临的一个基本问题。迄今为止，针对儿童获得医疗保健服务的研究和干预措施主要集中在医疗保健系统的政策层面特征（如医疗保险和医疗服务提供者的地理可及性），虽取得了一些成功，但成效有限。最终，获得医疗保健服务意味着进入医疗保健系统。实践预约系统是儿童获得初级保健服务的入口点，因此直接决定了儿科和家庭医学实践中获得医疗服务的机会。在此，我们从另一个角度探讨改善儿童获得医疗服务机会的基本原理：通过改进实践预约系统。我们的假设是，一些最有前景的当代改善儿童获得医疗服务机会的干预措施涉及改进初级保健预约系统。这些方法应补充成功的政策层面干预措施，以改善儿童获得医疗服务的机会。
