Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
J Adolesc Health. 2020 Jun;66(6):740-746. doi: 10.1016/j.jadohealth.2019.12.009. Epub 2020 Jan 25.
As teens in foster care prepare for emancipation, health care navigation is often overlooked, as caseworkers address other social needs. This study examined the impact of health care education materials designed for foster youth, called ICare2CHECK. It was hypothesized that ICare2CHECK would increase nonurgent ambulatory health care use and decrease emergency/urgent care use.
Adolescents (N = 151; aged 16-22 years) were enrolled in ICare2CHECK and received health education materials at their baseline study visit. Surveys were repeated every 3 months to assess health care utilization. After 12 months of enrollment, health care data for all eligible youth and matched comparison youth (N = 151) over the previous 24 months were extracted from the electronic health record (N = 302). Electronic health record data were coded as counts of completed nonurgent ambulatory care encounters (i.e., primary and preventative care and specialty care), completed urgent or emergency encounters (i.e., urgent and emergency department visits and hospitalizations), completed foster care clinic visits, and total completed visits.
Health care use significantly decreased over time for both enrolled and comparison youth. Females, youth engaging in health risk behaviors, and those with a mental health or chronic condition diagnosis used significantly more health care. Receipt of educational materials was associated with a smaller decline in health care use and nonurgent ambulatory care use, controlling for covariates. Self-reported use of educational materials was associated with increased utilization in the enrolled condition.
Results suggest that ICare2CHECK is associated with increased engagement in health care generally and nonurgent ambulatory care specifically (e.g., outpatient primary and specialty care).
随着寄养青少年准备成年，医疗保健导航通常被忽视，因为社工主要解决其他社会需求。本研究考察了为寄养青年设计的医疗保健教育材料 iCare2CHECK 的影响。假设 iCare2CHECK 将增加非紧急门诊保健的使用，并减少紧急/紧急护理的使用。
青少年（N=151；年龄 16-22 岁）参加了 iCare2CHECK，并在基线研究访问时收到了健康教育材料。每隔 3 个月进行一次调查，以评估医疗保健的使用情况。在登记后的 12 个月内，从电子健康记录（N=302）中提取了所有符合条件的青少年和匹配的对照青少年（N=151）在过去 24 个月内的医疗保健数据。电子健康记录数据被编码为已完成的非紧急门诊保健就诊次数（即初级和预防保健以及专科保健）、已完成的紧急或紧急就诊次数（即紧急和急诊就诊以及住院）、已完成的寄养诊所就诊次数和已完成的总就诊次数的计数。
无论登记还是对照青少年，医疗保健的使用都随着时间的推移而显著减少。女性、从事健康风险行为的青少年以及有心理健康或慢性疾病诊断的青少年使用的医疗保健服务明显更多。在控制了协变量的情况下，接受教育材料与医疗保健使用和非紧急门诊保健使用的下降幅度较小相关。自我报告的教育材料使用与登记条件下利用的增加有关。
结果表明，iCare2CHECK 通常与更广泛的医疗保健参与相关，特别是非紧急门诊保健（例如，门诊初级和专科保健）。
