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社区卫生工作者:通过融入医疗保健系统来改善人口健康。

Community health workers: improving population health through integration into healthcare systems.

机构信息

Drexel University Dornsife School of Public Health.

Drexel University College of Medicine.

出版信息

Curr Opin Pediatr. 2020 Oct;32(5):674-682. doi: 10.1097/MOP.0000000000000940.

Abstract

PURPOSE OF REVIEW

The purpose of this review is to describe the role, responsibilities, hiring, training, and retention of community health workers (CHWs) on clinical care teams in the United States.

RECENT FINDINGS

CHWs are unique members of clinical care teams because of their ability to foster a deep trust and understanding with patients by sharing similar life experiences, participating in home visits, and providing constant support and advocacy. By partnering with CHWs, other clinical care members also gain a better understanding of their patients allowing them to deliver more culturally competent, patient/family-centered care. CHWs when incorporated into interdisciplinary teams have shown to lower healthcare costs, reduce hospital stays and admissions, and improve health outcomes and quality of life for children and families. However, the lack of standardization among CHW programs makes it difficult to quantify the overall effect and impact of integrating CHWs into clinical care teams.

SUMMARY

CHWs are able to improve health outcomes and address social determinants of health when properly integrated into clinical care teams. However, without adequate support, integration, funding, and training, CHWs are not able to reach their full potential. The standardization of CHWs' responsibilities and training, like other clinical care team members, is lacking within the United States, making it a challenge to evaluate programs and maintain sustainable funding for these vital members of the clinical care team.

摘要

目的:本综述旨在描述美国临床护理团队中社区卫生工作者(CHW)的角色、职责、招聘、培训和留用情况。

发现:CHW 是临床护理团队中独特的成员,因为他们能够通过分享相似的生活经验、进行家访以及提供持续的支持和倡导,与患者建立深厚的信任和理解。通过与 CHW 合作,其他临床护理成员也能更好地了解他们的患者,从而提供更具文化适应性、以患者/家庭为中心的护理。将 CHW 纳入跨学科团队后,已显示出降低医疗保健成本、减少住院时间和住院次数、改善儿童和家庭的健康结果和生活质量的效果。然而,CHW 项目之间缺乏标准化,使得难以量化将 CHW 整合到临床护理团队中的总体效果和影响。

总结:当 CHW 得到适当整合到临床护理团队中时,他们能够改善健康结果并解决健康的社会决定因素。然而,如果没有足够的支持、整合、资金和培训,CHW 就无法充分发挥其潜力。在美国,CHW 的职责和培训标准化程度不足,这使得评估项目和为这些临床护理团队的重要成员维持可持续资金变得具有挑战性。

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