Addressing basic resource needs to improve primary care quality: a community collaboration programme
Addressing basic resource needs to improve primary care quality: a community collaboration programme
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DOI：
10.1136/bmjqs-2015-004521
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发表时间：
2016-03-01
影响因子：
5.4
通讯作者：
Atlas, Steven J.
中科院分区：
文献类型：
--
作者：
Berkowitz, Seth A.;Hulberg, A. Catherine;Atlas, Steven J.
背景：未满足的基本资源需求，如难以负担保健、药品、食品和住房，可能导致卫生保健质量指标恶化，但由于缺乏关于未满足的基本资源需求的分布及其与优先临床条件和卫生服务使用模式的关系的具体知识，干预措施受到阻碍。方法对2013年10月1日至2014年4月30日两个城市学术实践的初级保健患者进行横断面研究。对患者进行了未满足需求的筛查，并参加了一个将他们与社区资源联系起来的方案。主要措施包括患者报告未满足的基本资源需求，质量改进方案优先考虑的临床情况（高血压、糖尿病和抑郁症），以及卫生服务的使用模式，如频繁急诊科（ED）就诊（前一年为100万人次）和频繁门诊“不来”（前一年为100万人次）。结果纳入了416例未满足需求的患者，与未报告需求的2750例患者相比。报告中最常见的需求类型是：难以支付医疗保健（46.5%）、食品（40.1%）和水电费（36.3%）。报告需求未得到满足的患者更容易患抑郁症(17.8% vs 9.5%, p
Background Unmet basic resource needs, such as difficulty affording healthcare, medications, food and housing, may contribute to worse healthcare quality indicators, but interventions are hampered by lack of specific knowledge regarding the distribution of unmet basic resource needs and their association with priority clinical conditions and health service use patterns.Methods Cross-sectional study of primary care patients in two urban academic practices from 1 October 2013 to 30 April 2014. Patients were screened for unmet needs and enrolled in a programme to link them with community resources. Key measures included patient report of unmet basic resource needs, clinical conditions prioritised by quality improvement programmes (hypertension, diabetes and depression), and health service use patterns such as frequent emergency department (ED) visits (>2 in the preceding year) and frequent clinic 'no-shows' (>1 in the preceding year).Results 416 patients with unmet needs were included, and compared with 2750 patients who did not report needs. The most common types of needs reported were: difficulties affording healthcare (46.5%), food (40.1%) and utilities (36.3%). Patients who reported unmet needs were more likely to have depression (17.8% vs 9.5%, p