Rural Health Networks and Care Coordination: Health Care Innovation in Frontier Communities to Improve Patient Outcomes and Reduce Health Care Costs.
Rural Health Networks and Care Coordination: Health Care Innovation in Frontier Communities to Improve Patient Outcomes and Reduce Health Care Costs.
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DOI：
10.1353/hpu.2016.0181
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发表时间：
2016
影响因子：
1.4
通讯作者：
Bianco J
中科院分区：
文献类型：
--
作者：
Conway P;Favet H;Hall L;Uhrich J;Palche J;Olimb S;Tesch N;York-Jesme M;Bianco J
农村居民的健康受到高医疗保健费用、慢性病和影响农村医疗保健的政策决定的挑战。这种单一的情况下，嵌入式设计研究，以社区为基础的参与性研究原则和使用混合方法的指导下，描述了实施社区护理团队（CCT）和护理协调，以改善生活在边境社区的患者的结果。17个组织和165名成年人确定为潜在的护理协调候选人构成的目标人群。随着有条件现金援助的发展，各组织之间的合作和凝聚力得到加强。参与护理协调的患者报告了与全国同行相似的身体和较低的情绪健康生活质量;护理协调后急诊室的使用减少。在城市环境中被确定为成功的关键组成部分似乎适用于农村环境，重点是团队促进者的关键作用;需要为有复杂健康需求的人进行密集的护理协调，特别是行为健康需求;以及通过技术获得专业护理。
Rural residents’ health is challenged by high health care costs, chronic diseases, and policy decisions affecting rural health care. This single-case, embedded design study, guided by community-based participatory research principles and using mixed methods, describes outcomes of implementation of a community care team (CCT) and care coordination to improve outcomes of patients living in a frontier community. Seventeen organizations and 165 adults identified as potential care coordination candidates constituted the target populations. Following CCT development, collaboration and cohesion increased among organizations. Patients who participated in care coordination reported similar physical and lower emotional health quality of life than national counterparts; emergency department use decreased following care coordination. Key components identified as successful in urban settings seem applicable in rural settings, with emphasis on the key role of team facilitators; need for intense care coordination for people with complex health needs, especially behavioral health needs; and access to specialty care through technology.
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