Shi Leiyu, Lebrun Lydie A, Tsai Jenna, Zhu Jinsheng
Johns Hopkins University, Bloomberg School of Public Health, Dept. of Health Policy and Management, 624 North Broadway, Room 452, Baltimore, MD 21205, USA.
J Health Care Poor Underserved. 2010 Nov;21(4):1169-83. doi: 10.1353/hpu.2010.0928.
The overall aim was to determine whether health care delivery for vulnerable populations served by community health centers (CHCs) was comparable to care for mainstream Americans primarily seen in physicians' offices (POs). Data came from the 2006 National Ambulatory Medical Care Survey. Patient visits occurring in CHCs were largely from younger, uninsured or Medicaid-insured, minority populations, while POs catered mainly to older, Medicare- or privately-insured, White patients. Communities served by CHCs were more often in low-income, low-education, urban regions. A greater proportion of visits to CHCs were from diabetic, obese, and depressed patients; CHCs also offered more evening/weekend visits and provided more health education during visits, but spent less time per visit than POs and had more difficulty referring patients to specialists. Results affirmed the significant role of CHCs as safety-net providers for vulnerable populations, and indicated that CHCs provide adequate care compared with POs although there remains room for improvement.
总体目标是确定社区卫生中心(CHC)为弱势群体提供的医疗服务是否与主要在医生办公室(PO)为美国主流人群提供的医疗服务相当。数据来自2006年全国门诊医疗调查。在社区卫生中心进行的患者就诊主要来自年轻、未参保或参加医疗补助保险的少数族裔人群,而医生办公室主要服务于年龄较大、参加医疗保险或私人保险的白人患者。社区卫生中心服务的社区更多位于低收入、低教育水平的城市地区。到社区卫生中心就诊的患者中,糖尿病、肥胖症和抑郁症患者的比例更高;社区卫生中心还提供更多的夜间/周末就诊服务,就诊期间提供更多的健康教育,但每次就诊花费的时间比医生办公室少,并且在将患者转诊给专科医生方面困难更大。结果肯定了社区卫生中心作为弱势群体安全网提供者的重要作用,并表明与医生办公室相比,社区卫生中心提供了足够的医疗服务,尽管仍有改进空间。