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田纳西州汉考克县获得医疗保健障碍的探索:一项定性研究。

An exploration of barriers to access to healthcare in Hancock County, Tennessee: A qualitative study.

机构信息

Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, Texas, USA.

Department of Global Health and Population, T.H. Chan School of Public Health, Harvard University, Cambridge, Massachusetts, USA.

出版信息

Health Expect. 2024 Jun;27(3):e14074. doi: 10.1111/hex.14074.

Abstract

OBJECTIVE

Explore barriers to healthcare access in Hancock County, Tennessee using a conceptual framework for access to healthcare.

METHODS

We collected data from 30 participants in Hancock County during 1 week in April 2023 using a combination of network and purposive sampling. We analyzed the data using thematic analysis and the conceptual framework of healthcare access.

RESULTS

All dimensions of the conceptual framework of healthcare access presented barriers to healthcare access for participants of the study. A lack of acceptability of local healthcare among participants manifested in a perceived lack of availability of healthcare. This resulted in participants travelling or considering it necessary to travel long distances for care, even in a life-threatening emergency, despite the local availability of a hospital with an emergency department.

CONCLUSIONS

A lack of acceptability can create healthcare access barriers similar to a lack of availability of healthcare facilities.

PATIENT OR PUBLIC CONTRIBUTION

The research team met several times with the leader of a local community organization to discuss this research in Hancock County. These conversations helped to inform the study design and provided necessary background to conduct in-depth interviews. Members of the community organization helped identify individuals to interview and provide access to Remote Area Medical clinic patients. The research team discussed the final themes with the primary community collaborator.

摘要

目的

利用医疗保健获取概念框架,探索田纳西州汉考克县获取医疗保健的障碍。

方法

我们在 2023 年 4 月的一周内,通过网络和有针对性的抽样相结合,从汉考克县的 30 名参与者那里收集了数据。我们使用医疗保健获取的概念框架,通过主题分析对数据进行了分析。

结果

医疗保健获取概念框架的所有维度都为研究参与者获取医疗保健带来了障碍。参与者认为当地医疗保健机构不可接受,表现为医疗保健服务的可及性不足。这导致参与者即使在危及生命的紧急情况下,也会选择或认为有必要长途旅行去寻求医疗服务,尽管当地有一家配备了急诊部的医院。

结论

不可接受性会造成与医疗保健设施缺乏相似的医疗保健获取障碍。

患者或公众贡献

研究团队与当地一个社区组织的负责人多次会面,讨论在汉考克县开展这项研究。这些讨论有助于为研究设计提供信息,并提供了进行深入访谈的必要背景。社区组织的成员帮助确定了要采访的人,并提供了远程医疗诊所患者的访问途径。研究团队与主要的社区合作方讨论了最终的主题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a12/11106589/34124e01f281/HEX-27-e14074-g001.jpg

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