电子社区资源转介系统的系统评价。
A Systematic Review of Electronic Community Resource Referral Systems.
机构信息
The University of North Carolina at Chapel Hill, Center for Health Equity Research, Chapel Hill, North Carolina.
The University of North Carolina at Chapel Hill, Center for Health Equity Research, Chapel Hill, North Carolina.
出版信息
Am J Prev Med. 2023 Dec;65(6):1142-1152. doi: 10.1016/j.amepre.2023.06.001. Epub 2023 Jun 5.
INTRODUCTION
Community Resource Referral Systems delivered electronically through healthcare information technology systems (e.g., electronic medical records) have become more common in efforts to address patients' unmet health-related social needs. Community Resource Referral System connects patients with social supports such as food assistance, utility support, transportation, and housing. This systematic review identifies barriers and facilitators that influence the Community Resource Referral System's implementation in the U.S. by identifying and synthesizing peer-reviewed literature over a 15-year period.
METHODS
This systematic review was conducted following PRISMA guidelines. A search was conducted on five scientific databases to capture the literature published between January 2005 and December 2020. Data analysis was conducted from August 2021 to July 2022.
RESULTS
This review includes 41 articles of the 2,473 initial search results. Included literature revealed that Community Resource Referral Systems functioned to address a variety of health-related social needs and were delivered in different ways. Integrating the Community Resource Referral Systems into clinic workflows, maintenance of community-based organization inventories, and strong partnerships between clinics and community-based organizations facilitated implementation. The sensitivity of health-related social needs, technical challenges, and associated costs presented as barriers. Overall, electronic medical records-integration and automation of the referral process was reported as advantageous for the stakeholders.
DISCUSSION
This review provides information and guidance for healthcare administrators, clinicians, and researchers designing or implementing electronic Community Resource Referral Systems in the U.S. Future studies would benefit from stronger implementation science methodological approaches. Sustainable funding mechanisms for community-based organizations, clear stipulations regarding how healthcare funds can be spent on health-related social needs, and innovative governance structures that facilitate collaboration between clinics and community-based organizations are needed to promote the growth and sustainability of Community Resource Referral Systems in the U.S.
简介
通过医疗信息技术系统（例如电子病历）提供的社区资源转介系统在解决患者未满足的与健康相关的社会需求方面变得越来越普遍。社区资源转介系统将患者与社会支持（例如食品援助、水电费支持、交通和住房）联系起来。本系统评价通过识别和综合 15 年来的同行评议文献，确定并综合了影响美国社区资源转介系统实施的障碍和促进因素。
方法
本系统评价遵循 PRISMA 指南进行。在五个科学数据库上进行了搜索，以获取 2005 年 1 月至 2020 年 12 月期间发表的文献。数据分析于 2021 年 8 月至 2022 年 7 月进行。
结果
本综述包括从 2473 篇初始搜索结果中筛选出的 41 篇文章。纳入的文献表明，社区资源转介系统能够解决各种与健康相关的社会需求，并以不同的方式提供。将社区资源转介系统整合到诊所工作流程中、维护社区组织清单、以及诊所和社区组织之间建立强有力的伙伴关系，有助于系统的实施。健康相关社会需求的敏感性、技术挑战和相关成本被视为障碍。总体而言，电子病历整合和转介流程的自动化被报告为利益相关者带来了优势。
讨论
本综述为在美国设计或实施电子社区资源转介系统的医疗保健管理人员、临床医生和研究人员提供了信息和指导。未来的研究将受益于更强的实施科学方法方法。需要为社区组织建立可持续的资金机制、明确规定医疗保健资金可用于与健康相关的社会需求的方式，以及促进诊所和社区组织之间合作的创新治理结构，以促进美国社区资源转介系统的发展和可持续性。
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