未满足的医疗保健需求的认知：说旁遮普语和汉语的移民是怎么想的？一项定性研究。
Perceptions of unmet healthcare needs: what do Punjabi and Chinese-speaking immigrants think? A qualitative study.
机构信息
School of Nursing and Center for Health Services and Policy Research, University of British Columbia, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T-2B5, Canada. .ca.
出版信息
BMC Health Serv Res. 2010 Feb 22;10:46. doi: 10.1186/1472-6963-10-46.
BACKGROUND
Unmet healthcare needs - the difference between healthcare services deemed necessary to deal with a particular health problem and the actual services received - is commonly measured by the question, "During the past 12 months, was there ever a time when you felt that you needed healthcare, but you didn't receive it?" In 2003, unmet needs were reported by 10% of immigrants in Canada, yet, little is known specifically about Chinese- or Punjabi-speaking immigrants' perceptions and reporting of unmet needs. Our study examined: 1) How are unmet healthcare needs conceptualized among Chinese- and Punjabi-speaking immigrants? 2) Are their primary healthcare experiences related to their unmet healthcare needs?
METHODS
Twelve focus groups (6 Chinese, 6 Punjabi; n = 78) were conducted in Chinese or Punjabi and socio-demographic and health data were collected. Thematic analysis of focus group data examined the perceptions of unmet needs and any relationship to primary healthcare experiences.
RESULTS
Our analysis revealed two overarching themes: 1) defining an unmet healthcare need and 2) identifying an unmet need. Participants had unmet healthcare needs in relation to barriers to accessing care, their lack of health system literacy, and when the health system was less responsive than their expectations.
CONCLUSIONS
Asking whether someone ever had a time when they needed healthcare but did not receive it can either underestimate or overestimate unmet need. Measuring unmet need using single items is likely insufficient since more detail in a revised set of questions could begin to clarify whether the reporting of an unmet need was based on an expectation or a clinical need. Who defines what an unmet healthcare need is depends on the context (insured versus uninsured health services, experience in two or more healthcare systems versus experience in one healthcare system) and who is defining it (provider, patient, insurer).
背景
未满足的医疗保健需求是指认为处理特定健康问题所需的医疗保健服务与实际所接受的服务之间的差距。通常通过以下问题来衡量：“在过去的 12 个月中，是否有过您感到需要医疗保健但未得到的情况？”2003 年，加拿大移民中有 10%报告存在未满足的需求，但具体而言，关于讲中文或旁遮普语的移民对未满足需求的看法和报告却知之甚少。我们的研究考察了：1）讲中文和旁遮普语的移民如何理解未满足的医疗保健需求？2）他们的初级保健经历与未满足的医疗保健需求有关吗？
方法
以中文或旁遮普语进行了 12 个焦点小组（6 个中文组，6 个旁遮普语组；n=78），收集了社会人口统计学和健康数据。对焦点小组数据的主题分析考察了对未满足需求的看法以及与初级保健经历的任何关系。
结果
我们的分析揭示了两个总体主题：1）定义未满足的医疗保健需求，2）确定未满足的需求。参与者在获得医疗保健服务方面存在障碍，缺乏卫生系统知识，以及卫生系统的反应不如他们预期的那样积极时，都存在未满足的医疗保健需求。
结论
询问某人是否曾经有过需要医疗保健但未得到的情况，可能会低估或高估未满足的需求。使用单一项目来衡量未满足的需求可能不够充分，因为在修订后的问题集中增加更多细节可以开始澄清报告的未满足需求是基于期望还是临床需求。谁来定义什么是未满足的医疗保健需求取决于背景（有保险与无保险的医疗服务、在两个或更多医疗保健系统中的经验与在一个医疗保健系统中的经验）以及谁在定义（提供者、患者、保险人）。
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