Department of Family Medicine, Carolinas Healthcare System, University of North Carolina, Charlotte, NC, USA.
J Am Board Fam Med. 2010 Jan-Feb;23(1):109-20. doi: 10.3122/jabfm.2010.01.090136.
BACKGROUND: Hispanics are the largest and fastest growing minority group in the United States. Charlotte, NC, had the 4th fastest growing Hispanic community in the nation between 1990 to 2000. Gaining understanding of the patterns of health care use for this changing population is a key step toward designing improved primary care access and community health. METHODS: The Multiple Attribute Primary Care Targeting Strategy process was applied to key patient- and community-level attributes describing the Charlotte Hispanic community. Maps were created based on socioeconomic status, population density, insurance status, and use of the emergency department as a primary care safety net. Each of these variables was weighed and added to create a single composite map. RESULTS: Individual attribute maps and the composite map identified geographic locations where Hispanic community members would most benefit from increased access to primary care services. CONCLUSIONS: Using the Multiple Attribute Primary Care Targeting Strategy process we were able to identify geographic areas within our community where many Hispanic immigrants face barriers to accessing appropriate primary care services. These areas can subsequently be targeted for interventions that improve access to primary care and reduce emergency department use. The geospatial model created through this process can be monitored over time to determine the effectiveness of these interventions.
背景:西班牙裔是美国最大和增长最快的少数族裔群体。1990 年至 2000 年期间,北卡罗来纳州夏洛特市是全国西班牙裔社区增长第四快的城市。了解这一不断变化的人口的医疗保健使用模式是设计改善初级保健服务获取和社区健康的关键步骤。
方法:应用多属性初级保健目标定位策略流程,对描述夏洛特西班牙裔社区的关键患者和社区层面属性进行描述。根据社会经济地位、人口密度、保险状况以及将急诊室用作初级保健安全网的情况绘制地图。对这些变量进行加权并添加到创建一个单一的综合地图中。
结果:各个属性地图和综合地图确定了西班牙裔社区成员最需要增加初级保健服务获取的地理位置。
结论:我们能够使用多属性初级保健目标定位策略流程来确定我们社区内许多西班牙裔移民在获得适当初级保健服务方面面临障碍的地理区域。随后,可以针对这些区域进行干预,以改善初级保健服务的获取并减少急诊室的使用。通过该流程创建的地理空间模型可以随着时间的推移进行监测,以确定这些干预措施的有效性。
J Am Board Fam Med. 2010
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