Ryvicker Miriam
Center for Home Care Policy and Research, Visiting Nurse Service of New York, 1250 Broadway, 7th Floor, New York, NY 10001, ,
Soc Theory Health. 2018 Aug;16(3):224-240. doi: 10.1057/s41285-017-0053-2. Epub 2017 Oct 23.
This paper introduces a conceptual framework for investigating individual ability to navigate healthcare in the contexts of the built environment, social environment, and healthcare infrastructure in which a person is embedded. Given the complexity of healthcare delivery in the United States, consumers are expected to have an increasingly sophisticated set of skills in order to effectively navigate and benefit from the healthcare resources available to them. Addressing barriers to navigation in vulnerable populations may be essential to reducing health disparities. This paper builds on previous conceptual developments in the areas of healthcare use, navigation, and ecological perspectives on health in order to present a behavioral-ecological framework for examining healthcare navigation and access. The model posits that healthcare navigation is an ecologically informed process not only because of the spatial distribution of health services, but because of the spatial distribution of individual and environmental factors that influence decision-making and behavior with respect to service use. The paper discusses areas for further research on healthcare navigation, challenges for research, and implications for reducing health disparities.
本文介绍了一个概念框架，用于研究个体在所处的建筑环境、社会环境和医疗基础设施背景下驾驭医疗保健系统的能力。鉴于美国医疗服务提供的复杂性，消费者需要具备一套日益复杂的技能，以便有效地利用现有的医疗资源并从中受益。解决弱势群体在医疗保健导航方面的障碍对于减少健康差距可能至关重要。本文基于先前在医疗保健利用、导航以及健康生态视角等领域的概念发展，提出了一个行为生态框架，用于审视医疗保健导航和获取情况。该模型认为，医疗保健导航是一个基于生态的过程，这不仅是因为健康服务的空间分布，还因为影响服务使用决策和行为的个体及环境因素的空间分布。本文讨论了医疗保健导航领域进一步研究的方向、研究面临的挑战以及对减少健康差距的启示。
