Jensen Natasja Koitzsch, Nielsen Signe Smith, Krasnik Allan
Copenhagen University, Faculty of Health Sciences, Institute of Public Health, Department of Health Services Research, Danish Research Centre for Migration, Ethnicity and Health, Denmark.
Dan Med Bull. 2010 Aug;57(8):A4170.
Delivery of health care to immigrants is an emerging field of interest. Immigrants are frequently characterised by health outcomes that are inferior to those of other groups with regard to morbidity and mortality. In addition, health professionals report difficulties associated with the encounter with immigrant patients.
A Delphi process with eight Danish experts from the field of immigrant health was performed as part of an EU project. The objective of the Delphi process was to investigate expert opinion on "best practice in the delivery of healthcare to immigrants". Initially, 60 factors were suggested by the experts. Next, these factors were summarised into 32 factors that the experts were invited to rate and, if possible, agree on.
The top 11 factors identified in the Delphi process were access to interpreters, quality of interpretation, ensuring medication compliance, having sufficient consultation time, coherence of offers, interdisciplinary collaboration, allocation of resources, the role of the practitioner, acknowledgement of the individual patient, education of health professionals and students and access to telephone interpretation to supplement other services.
The Delphi process can be a valuable tool in the investigation of expert opinion and may thereby help to guide future policy directives. In the light of the importance experts placed on access to interpreters and on the quality of the interpretation services offered, it seems as an untenable strategy to introduce as from June 2011 self-payment for interpretation services provided to immigrants who have stayed in the country for more than seven years.
为移民提供医疗保健是一个新兴的研究领域。在发病率和死亡率方面,移民的健康状况往往比其他群体差。此外,医疗专业人员报告称,在与移民患者接触时存在困难。
作为欧盟项目的一部分,对来自移民健康领域的八位丹麦专家进行了德尔菲法。德尔菲法的目的是调查专家对“为移民提供医疗保健的最佳实践”的意见。最初,专家们提出了60个因素。接下来,这些因素被归纳为32个因素,邀请专家对其进行评分,并尽可能达成共识。
德尔菲法确定的前11个因素是:获得口译员服务、口译质量、确保药物依从性、有足够的咨询时间、服务的连贯性、跨学科合作、资源分配、从业者的角色、对个体患者的认可、医疗专业人员和学生的教育以及获得电话口译以补充其他服务。
德尔菲法可以成为调查专家意见的宝贵工具,从而有助于指导未来的政策指令。鉴于专家们对获得口译员服务以及所提供口译服务质量的重视,从2011年6月起对在该国居住超过七年的移民提供的口译服务实行自付费用,似乎是一项站不住脚的策略。