Knowles Molly, Crowley Aidan P, Vasan Aditi, Kangovi Shreya
Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; email:
Penn Center for Community Health Workers, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Annu Rev Public Health. 2023 Apr 3;44:363-381. doi: 10.1146/annurev-publhealth-071521-031648.
Community health workers (CHWs) have worked in a variety of settings in the United States for more than 70 years and are increasingly recognized as an essential health workforce. CHWs share life experience with the people they serve and have firsthand knowledge of the causes and impacts of health inequity. They provide a critical link between marginalized communities and health care and public health services. Several studies have demonstrated that CHWs can improve the management of chronic conditions, increase access to preventive care, improve patients' experience of care, and reduce health care costs. CHWs can also advance health equity by addressing social needs and advocating for systems and policy change. This review provides a history of CHW integration with health care in the United States; describes evidence of the impact of CHW programs on population health, experience, costs of care, and health equity; and identifies considerations for CHW program expansion.
在美国，社区卫生工作者（CHWs）已经在各种环境中工作了70多年，并且越来越被视为一支重要的卫生人力队伍。社区卫生工作者与他们所服务的人群有着共同的生活经历，并且对健康不平等的原因和影响有着第一手的了解。他们在边缘化社区与医疗保健及公共卫生服务之间提供了关键的联系。多项研究表明，社区卫生工作者可以改善慢性病的管理，增加获得预防性护理的机会，改善患者的就医体验，并降低医疗保健成本。社区卫生工作者还可以通过满足社会需求以及倡导系统和政策变革来促进健康公平。本综述提供了美国社区卫生工作者融入医疗保健的历史；描述了社区卫生工作者项目对人群健康、就医体验、护理成本和健康公平影响的证据；并确定了社区卫生工作者项目扩展的考虑因素。
