University of Washington, Seattle, WA, USA.
Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Health Promot Pract. 2022 May;23(3):416-424. doi: 10.1177/15248399211002832. Epub 2021 Apr 14.
A community health center (CHC) implemented a medical-dental integration (MDI) program where children were seen at a pediatric medical clinic or women, infants, and children program location by medical and dental providers in the same visit. Our study aims were to elicit the perspectives and experiences of providers and administrators involved in the MDI program to assess the acceptability, feasibility, and success of a CHC integration strategy in Eastern Washington.
This is a qualitative study where we conducted semistructured interviews over the phone over a period of 2 months with 12 medical and dental providers and clinical administrators who were involved with the MDI program. Questions addressed perspectives on workflow, patient identification and engagement, leadership support, and barriers and facilitators of the initiative. Qualitative data were analyzed, and emergent themes were identified.
The emergent themes included (a) the MDI program is feasible and acceptable albeit with key considerations regarding the setting, including charting and service integration, progressive leadership and effective communication, and appropriate providers; (b) implementation included structural, systemic, and individual behavior barriers, (c) the program is seen as a benefit to the clinic and patients and a success to date as a way to increase access to quality care.
Findings from this study helped identify facilitators, such as cultural relevancy and progressive office systems, as well as barriers, such as reimbursement, associated with integrating medical and dental care in a rural CHC setting, is acceptable by providers, and can inform future studies and implementation strategies for others wishing to integrate these services.
一家社区健康中心（CHC）实施了一项医疗-牙科整合（MDI）计划，该计划允许医疗和牙科提供者在同一次就诊中为儿科医疗诊所或妇女、婴儿和儿童计划地点的儿童提供服务。我们的研究目的是了解参与 MDI 计划的提供者和管理人员的观点和经验，以评估华盛顿东部 CHC 整合策略的可接受性、可行性和成功。
这是一项定性研究，我们在 2 个月的时间里通过电话对 12 名参与 MDI 计划的医疗和牙科提供者和临床管理人员进行了半结构化访谈。问题涉及对工作流程、患者识别和参与、领导力支持以及该计划的障碍和促进因素的看法。对定性数据进行了分析，并确定了出现的主题。
出现的主题包括（a）MDI 计划是可行和可接受的，尽管需要考虑到设置方面的一些关键因素，包括图表和服务整合、渐进式领导力和有效的沟通以及适当的提供者；（b）实施过程中存在结构、系统和个人行为障碍；（c）该计划被认为对诊所和患者有益，并且是迄今为止增加获得高质量护理的一种成功方式。
这项研究的结果有助于确定促进因素，例如文化相关性和渐进式办公系统，以及障碍，例如报销，这些与在农村 CHC 环境中整合医疗和牙科护理相关，该计划得到了提供者的认可，并可以为其他希望整合这些服务的人提供未来的研究和实施策略。
