Centro Regional de Enfermedades Autoinmunes y Reumáticas (GO-CREAR), Bv. Oroño 1024, Rosario, Santa Fe, Argentina.
CEAPROS (Centro de Estudios Aplicados a Problemáticas Socio-culturales), Facultad de Humanidades y Artes, Universidad Nacional de Rosario (UNR), Rosario, Argentina.
Clin Rheumatol. 2021 Jun;40(6):2407-2417. doi: 10.1007/s10067-020-05513-6. Epub 2020 Nov 24.
INTRODUCTION/OBJECTIVES: The objective of this study is to describe the local healthcare system from the perspective of the health professionals, community health workers, and local representatives of the qom community living in the province of Chaco, Argentina.
A qualitative study, with an ethnographic approach, was carried out using two techniques: non-participant observations and semi-structured interviews. A guide for the interviews was designed and developed by a multidisciplinary group of GLADERPO researchers. The main aspects included were the following: reference into the local healthcare system and accessibility to the system. Andersen's base conceptual model of health service utilization was applied for the analysis and for structuring the results.
A total of 21 people were interviewed, twelve women and nine men with an age ranging between 25 and 60 years old. The main findings were different barriers (communication and cultural) between the community and the healthcare system; "navigation" within the health system carried out by the qom community; and migration and bureaucratization of the health system.
These findings should be incorporated into educational strategies to improve access to healthcare system and adherence to medical treatment, establishing an interaction between the different levels of the local care system and providing community health workers with an appropriate training with the support of the community representatives. Key Points • The different barriers between the community and the healthcare system were described. • The "navigation" within the health system carried out by the qom community and the migration were relevant points. • The bureaucratization of the health system and the need to design and implement educational strategies in the future were highlighted.
介绍/目标：本研究的目的是从卫生专业人员、社区卫生工作者和居住在阿根廷查科省的孔科社区的当地代表的角度描述当地的医疗保健系统。
采用定性研究方法，具有民族志方法，使用了两种技术：非参与式观察和半结构化访谈。由 GLADERPO 研究人员组成的多学科小组设计并开发了访谈指南。访谈的主要内容包括以下方面：进入当地医疗保健系统的途径和系统的可及性。安德森健康服务利用的基本概念模型用于分析和构建结果。
共访谈了 21 人，其中 12 名女性和 9 名男性，年龄在 25 岁至 60 岁之间。主要发现是社区和医疗保健系统之间存在不同的障碍（沟通和文化）；孔科社区在医疗系统中的“导航”；以及医疗系统的迁移和官僚化。
这些发现应纳入教育策略，以改善获得医疗保健系统和治疗的机会，建立当地护理系统各级之间的互动，并为社区卫生工作者提供适当的培训，同时得到社区代表的支持。
• 描述了社区和医疗保健系统之间的不同障碍。• 孔科社区在医疗系统中的“导航”和迁移是相关要点。• 强调了医疗系统的官僚化以及未来设计和实施教育策略的必要性。
