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定性案例研究:一项旨在改善内城弱势社区医疗整合的试点项目。

Qualitative Case Study: A Pilot Program to Improve the Integration of Care in a Vulnerable Inner-City Community.

作者信息

Williamson Margaret Frances, Song Hyun Jung, Dougherty Louise, Parcsi Lisa, Barr Margo Linn

机构信息

University of NSW, AU.

University of NSW and Sydney Local Health District, AU.

出版信息

Int J Integr Care. 2022 May 16;22(2):15. doi: 10.5334/ijic.6184. eCollection 2022 Apr-Jun.

Abstract

INTRODUCTION

There is a strong correlation between vulnerable populations and poor health outcomes. Growing evidence suggests that person-centred interventions using 'link workers' can support communities to navigate and engage with health and community services, leading to improved health service access. We describe the initial phase and qualitative evaluation of a Healthy Living Program, supported by a link worker role. The Program aimed to improve health service access for residents of an Australian inner-city suburb.

METHODS

To inform future program development, semi-structured interviews were conducted with clients and stakeholders (n = 21). The interviews were analysed thematically to understand program impact, success factors, constraints and potential improvements.

RESULTS

Key themes relating to impacts were a new model of working with community, improved access to services, and responsiveness to community need. Key factors for success included being a trusted, consistent presence, having knowledge of the community and health system, and successful engagement with the community and stakeholders. The constraints included difficulty influencing health system change and lack of community input. Suggested improvements were expanding the service, enhancing health system change and increasing community involvement.

CONCLUSION

Knowledge gained from this study will inform future integrated approaches in health districts to address health inequities in areas of need.

摘要

引言

弱势群体与不良健康结果之间存在密切关联。越来越多的证据表明,采用“联络人员”的以患者为中心的干预措施能够帮助社区利用并参与健康及社区服务,从而改善医疗服务的可及性。我们描述了一项由联络人员角色支持的健康生活计划的初始阶段及定性评估。该计划旨在改善澳大利亚一个内城区郊区居民的医疗服务可及性。

方法

为指导未来的项目开发,我们对客户和利益相关者(n = 21)进行了半结构化访谈。对访谈进行了主题分析,以了解项目的影响、成功因素、制约因素和潜在改进之处。

结果

与影响相关的关键主题包括与社区合作的新模式、服务可及性的改善以及对社区需求的响应能力。成功的关键因素包括成为受信任的、持续存在的力量,了解社区和卫生系统,以及成功地与社区和利益相关者互动。制约因素包括难以影响卫生系统变革以及缺乏社区参与。建议的改进措施包括扩大服务范围、加强卫生系统变革以及增加社区参与度。

结论

从本研究中获得的知识将为未来健康区解决需求地区健康不平等问题的综合方法提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c07/9122010/2f73272d6a01/ijic-22-2-6184-g1.jpg

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