Joshi Praphul, Marino Marisa, Bhoi Alok, McCoy Natasha
Center for Community and Public Health, University of New England, Portland, ME, USA.
J Cardiovasc Dis Res. 2012 Oct;3(4):305-9. doi: 10.4103/0975-3583.102711.
Chronic diseases, particularly cardiovascular diseases and diabetes, continue to lead the way with regard to mortality as well as morbidity in the United States. Despite several efforts to prevent the onset of these diseases in the last couple of decades, the burden of chronic diseases continues to rise. The burden of chronic diseases has increased more rapidly among disparate populations, particularly among ethnic minorities, rural, and those in the lower socio-economic status.
In an effort to reach the disparate populations, health disparities collaborative was implemented in Louisiana in 2010 in three federally qualified health centers to improve delivery of quality care and improve health outcomes for patients diagnosed with diabetes and heart disease.
A qualitative study was conducted using individual face-to-face interviews at each clinical site to assess the level of implementation, satisfaction with the initiative, and challenges and barriers in implementing the initiative. Data in this qualitative study were analyzed using interpretative coding.
All three clinical sites expressed satisfaction in implementing the collaborative and appreciated the coordinated efforts to treat chronic diseases among their patients.
Although the implementation of chronic disease collaborative appeared to be very successful based on the qualitative data as well as clinical outcomes, several challenges in implementation were observed. Results of the study indicated a need for strong leadership at the clinical sites, enhanced communication efforts to engage the collaborative team, and increased emphasis on patient education for successful implementation of the collaborative.
在美国,慢性病,尤其是心血管疾病和糖尿病,在死亡率和发病率方面仍然占据主导地位。尽管在过去几十年里为预防这些疾病的发生做出了多项努力,但慢性病的负担仍在持续上升。慢性病的负担在不同人群中增长得更快,尤其是少数族裔、农村地区以及社会经济地位较低的人群。
为了惠及不同人群,2010年在路易斯安那州的三个联邦合格健康中心实施了健康差异协作项目,以改善对糖尿病和心脏病患者的优质护理服务并改善其健康状况。
在每个临床站点进行个人面对面访谈,开展一项定性研究,以评估实施水平、对该项目的满意度以及实施该项目过程中的挑战和障碍。本定性研究中的数据采用解释性编码进行分析。
所有三个临床站点都对实施协作表示满意,并赞赏为治疗其患者的慢性病所做的协调努力。
尽管从定性数据以及临床结果来看,慢性病协作项目的实施似乎非常成功,但仍观察到实施过程中的一些挑战。研究结果表明,为了协作项目的成功实施,临床站点需要强有力的领导、加强沟通以促使协作团队参与,以及更加重视患者教育。