为无家可归儿童提供优质医疗保健：实现美国儿科学会对无家可归儿童和青少年护理的建议。
Quality Health Care for Homeless Children: Achieving the AAP Recommendations for Care of Homeless Children and Youth.
作者信息
Chatterjee Avik, So Marvin, Dunleavy Spencer, Oken Emily
出版信息
J Health Care Poor Underserved. 2017;28(4):1376-1392. doi: 10.1353/hpu.2017.0121.
BACKGROUND
We assessed whether and how health care organizations serving homeless pediatric patients meet recommendations issued by the American Academy of Pediatrics (AAP).
METHODS
We conducted a web-based survey of Health Care for the Homeless (HCH) Program grantees serving children.
RESULTS
Of 169 grantees, 77 (46%) responded. All organizations reported connecting patients to specialty services. Nearly all reported screening for homelessness (90%), facilitating Medicaid enrollment (90%), connecting patients to benefits (94%), addressing underlying causes of homelessness (83%), assisting with transportation (83%), and knowing about the causes of homelessness (76%). Fewer reported integrating comprehensive care into acute visits (61%) or having medical-legal partnerships (57%). Federally qualified health center status was associated with meeting more recommendations. We described barriers and facilitators to meeting recommendations.
DISCUSSION
Health care organizations serving homeless children largely meet AAP recommendations, but integrating comprehensive care into acute visits remains an area for improvement. Disseminating best practices may support guideline adherence.
背景
我们评估了为无家可归的儿科患者提供服务的医疗保健机构是否以及如何符合美国儿科学会（AAP）发布的建议。
方法
我们对为儿童提供服务的无家可归者医疗保健（HCH）项目受资助机构进行了一项基于网络的调查。
结果
169个受资助机构中，77个（46%）做出了回应。所有机构都报告为患者提供了专科服务。几乎所有机构都报告进行了无家可归状况筛查（90%）、协助医疗补助登记（90%）、帮助患者获得福利（94%）、解决无家可归的根本原因（83%）、协助交通安排（83%）以及了解无家可归的原因（76%）。较少机构报告在急症就诊中整合综合护理（61%）或建立医疗 - 法律伙伴关系（57%）。获得联邦资格认定的健康中心状态与符合更多建议相关。我们描述了符合建议的障碍和促进因素。
讨论
为无家可归儿童提供服务的医疗保健机构在很大程度上符合AAP的建议，但将综合护理整合到急症就诊中仍是一个有待改进的领域。传播最佳实践可能有助于遵循指南。
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