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跨专业协作护理的机会——来自中西部联邦合格健康中心患者样本的研究结果

Opportunity for interprofessional collaborative care-findings from a sample of federally qualified health center patients in the Midwest.

作者信息

Smith L J, Johnson-Lawrence V, Andrews M, Parker S

机构信息

Department of Physical Therapy, University of Michigan-Flint, 2157 William S. White Building, 303 E. Kearsley Street, Flint, MI 48502, USA.

Department of Public Health and Health Sciences, University of Michigan-Flint, 3124 William S. White Building, 303 E. Kearsley Street, Flint, MI 48502, USA.

出版信息

Public Health. 2017 Oct;151:131-136. doi: 10.1016/j.puhe.2017.07.009. Epub 2017 Aug 7.

Abstract

OBJECTIVES

Federally qualified health centers (FQHCs) frequently serve more socio-economically disadvantaged populations; existing literature suggests that underserved groups are more likely to experience various chronic physical and mental health conditions. FQHC patients may have significant needs for various specialty services that are beyond common FQHC providers. This study examines chronic condition prevalence, healthcare satisfaction, and use of multiprovider services in a Midwest FQHC patient population. We also evaluated the potential of interprofessional collaborative practices in FQHC settings.

STUDY DESIGN

Cross-sectional study.

METHODS

A total of 232 participants were recruited prior to or immediately after their scheduled clinic visit within an FQHC located on the fringes of an urban area. Respondents were invited to complete a brief questionnaire and grant access to their electronic medical records.

RESULTS

Nearly half of participants were covered by Medicaid, private insurance carriers (19.4%), or Medicare (17.7%). The most prevalent chronic conditions included diabetes, depression, anxiety, and chronic pain. Almost half (46.6%) of participants were seen by two or three providers; 20% had 7+ office visits in the last year. While 35.3% reported health dissatisfaction, 30.6% reported health satisfaction. When asked if they were satisfied with their health care, nearly 70% reported satisfaction with health care, while only 4.7% reported healthcare dissatisfaction.

CONCLUSIONS

The authors of this study recommend an interprofessional collaborate healthcare model be explored to address the complex and multifaceted healthcare needs of this population. Future research in this area should prospectively examine the utility of monitoring patient satisfaction in a collaborative practice setting.

摘要

目标

联邦合格健康中心(FQHCs)经常为社会经济地位较低的人群提供服务;现有文献表明,未得到充分服务的群体更有可能患有各种慢性身心健康疾病。FQHC的患者可能对各种专科服务有重大需求,而这些需求超出了普通FQHC提供者的能力范围。本研究调查了中西部地区FQHC患者群体中的慢性病患病率、医疗满意度以及多提供者服务的使用情况。我们还评估了FQHC环境中跨专业协作实践的潜力。

研究设计

横断面研究。

方法

在位于市区边缘的一家FQHC内,共有232名参与者在预定的门诊就诊前或就诊后立即被招募。受访者被邀请填写一份简短的问卷,并允许获取他们的电子病历。

结果

近一半的参与者由医疗补助、私人保险公司(19.4%)或医疗保险(17.7%)承保。最常见的慢性病包括糖尿病、抑郁症、焦虑症和慢性疼痛。近一半(46.6%)的参与者看过两三位医生;20%的人在过去一年中有7次以上的门诊就诊。虽然35.3%的人表示对健康不满意,但30.6%的人表示对健康满意。当被问及是否对医疗保健满意时,近70%的人表示对医疗保健满意,而只有4.7%的人表示对医疗保健不满意。

结论

本研究的作者建议探索一种跨专业协作的医疗模式,以满足该人群复杂多面的医疗需求。该领域未来的研究应前瞻性地考察在协作实践环境中监测患者满意度的效用。

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