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基于团队的残疾人初级保健方案和未满足的卫生保健需求发生率的变化。

Team-based primary care program for disabled people and changes in rate of unmet health care needs.

机构信息

Nursing Policy Bureau, Korean Nurses Association, Seoul, Republic of Korea.

Policy Bureau, Cooperative Institute for Health Plus, Ansan, Republic of Korea.

出版信息

Fam Pract. 2021 Mar 29;38(2):95-102. doi: 10.1093/fampra/cmaa089.

Abstract

BACKGROUND

Few studies have been conducted on the application of specific and practical methods, such as interventions, for reducing the unmet health care needs (UHCN) of disabled people.

OBJECTIVES

The study aims to evaluate the impact of the team-based primary care program (TPCP) for disabled people on UHCN.

METHOD

In 2017, we surveyed 696 disabled people who were enrolled in the TPCP at one of the 11 institutions belonging to the Korea Health Welfare Social Cooperative Federation from 2015 to 2017 to assess their unmet needs before and after enrolment. We conducted a logistic regression analysis before and after the program to evaluate the relationship between participation period and unmet needs after adjusting for physician type, gender, age, drinking, monthly income, disability type, personal assistance services and living alone.

RESULT

After using the service, the proportion of disabled people with unmet needs decreased from 42.9% to 20.4% for a medical doctor and 43.6% to 18.6% for a Korean medical (KM) doctor. After adjusting for related factors and stratifying with type of physician, the proportion of disabled people with unmet needs decreased significantly in response to the participation period for the medical doctor-involved program (P-trend < 0.001); this was not observed in the KM counterpart (P-trend = 0.6).

CONCLUSION

The TPCP for disabled people provides disease prevention, health care and health promotion activities and is crucial for solving the unmet needs.

摘要

背景

针对减少残疾人未满足的卫生保健需求(UHCN),鲜有研究关注特定且实用的干预方法的应用。

目的

本研究旨在评估以团队为基础的基层医疗保健计划(TPCP)对残疾人 UHCN 的影响。

方法

2017 年,我们调查了参加韩国保健福利协同组合所属的 11 家机构的 TPCP 的 696 名残疾人,以评估他们在参加 TPCP 前后的未满足需求。我们对计划实施前后进行了逻辑回归分析,在调整医生类型、性别、年龄、饮酒、月收入、残疾类型、个人援助服务和独居等因素后,评估参与期与未满足需求之间的关系。

结果

使用该服务后,接受医生服务的残疾人未满足需求的比例从 42.9%降至 20.4%,接受韩医服务的比例从 43.6%降至 18.6%。在调整相关因素并按医生类型分层后,接受医生参与的 TPCP 的残疾人未满足需求的比例随着参与期的延长而显著下降(趋势 P < 0.001);而在韩医参与的 TPCP 中未观察到这种趋势(趋势 P = 0.6)。

结论

残疾人 TPCP 提供疾病预防、保健和健康促进活动,对于解决未满足的需求至关重要。

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