Countouris Malamo, Gilmore Sandra, Yonas Michael
School of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
UPMC Staying at Home Program, Aging Institute of UPMC, University of Pittsburgh Medical Center (UPMC) and the University of Pittsburgh, 3600 Forbes Avenue, Pittsburgh, PA 15213, USA.
Health Place. 2014 Mar;26:143-8. doi: 10.1016/j.healthplace.2013.11.008. Epub 2013 Dec 27.
The closing of hospitals has exacerbated challenges for older adults in accessing healthcare, especially those living in economically underserved settings. Through focus groups and a community-engaged approach, our study examined and documented the emergent health needs of older adults following the closing of a local hospital in an economically disadvantaged community. Focus groups were reconvened to assess progress and health needs over time. Analyses of the focus groups (n=37, mean age 77, 84% female) illustrated the impact of the closure and the emergence of the following dominant themes: perceptions of the hospital system, including feelings of abandonment and social isolation; transportation challenges in accessing health care resources; and lack of knowledge and literacy regarding available health care and obtaining health services. Discussion sessions with hospital administrators and participants afforded an opportunity for sharing data and additional assessment. The data and relationships developed with community participants and health system representatives resulted in the production of an information resource about access to health services, tailored for older adults.
医院的关闭加剧了老年人在获取医疗保健方面面临的挑战,尤其是那些生活在经济欠发达地区的老年人。通过焦点小组和社区参与的方法,我们的研究调查并记录了经济弱势社区中一家当地医院关闭后老年人新出现的健康需求。随着时间的推移,重新召集焦点小组以评估进展情况和健康需求。对焦点小组(n = 37,平均年龄77岁,84%为女性)的分析表明了医院关闭的影响以及以下主要主题的出现:对医院系统的看法,包括被遗弃感和社会孤立感;获取医疗资源时的交通挑战;以及对可用医疗保健和获得医疗服务的知识和素养的缺乏。与医院管理人员和参与者的讨论会议提供了一个分享数据和进行额外评估的机会。与社区参与者和卫生系统代表建立的数据和关系促成了一份针对老年人的关于获取医疗服务的信息资源的产生。