US Medical-Legal Partnerships to Address Health-Harming Legal Needs: Closing the Health Injustice Gap.
US Medical-Legal Partnerships to Address Health-Harming Legal Needs: Closing the Health Injustice Gap.
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美国医疗法律合作伙伴关系解决危害健康的法律需求：缩小健康不公正差距。
DOI：
10.1007/s11606-023-08546-0
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发表时间：
2024
影响因子：
5.7
通讯作者：
Tung,ElizabethL
中科院分区：
文献类型：
--
作者：
Johnson,DanielY;Asay,Spencer;Keegan,Grace;Wu,Lisa;Zietowski,MaesonL;Zakrison,TanyaL;Muntz,Nathan;Pillai,Rhea;Tung,ElizabethL
医疗法律伙伴关系（MLP）模式正在美国各地兴起，成为解决健康不公正背后的不利社会条件的有力工具。MLP将法律的专家嵌入医疗团队，以通过民事法律的补救措施解决损害健康的法律的需求。我们对2007年至2022年期间发表的同行评审文章进行了叙述性综述，以描述美国MLP对患者，提供者和医疗保健系统的结构和影响。我们发现，MLP主要通过将法律的专家融入社区临床环境或儿童医院，为弱势患者群体提供服务，尽管患者群体和环境差异很大。在大多数模式中，医疗保健提供者接受过培训，以筛选患者的法律的需求，并将他们转介给法律的专家。小额贷款伙伴提供广泛的服务，例如协助获得公共福利（例如，社会保障，医疗补助，现金援助）和移民和家庭法事务的法律的代表。病人及其家属也从增加对法律的权利和制度的了解中受益。虽然证据基础仍处于初期阶段，但现有研究表明，MLP与更多的医疗服务，更少的住院治疗以及改善身心健康结果有关。从事MLP的医疗和法律的提供者报告了跨学科的学习，医疗保健系统通常通过节省成本和增加医疗补助报销而获得高投资回报。许多地方立法机构还开展宣传和教育，以实现与人口健康和社会需求有关的更广泛的政策变革。为了优化MLP模型，建议进行更严格的研究，系统的实施实践，评估指标和可持续的资金机制。将MLP更广泛地纳入医疗保健系统有助于解决美国历史上边缘化人群健康不平等的根本原因。
The medical-legal partnership (MLP) model is emerging across the USA as a powerful tool to address the adverse social conditions underlying health injustice. MLPs embed legal experts into healthcare teams to address health-harming legal needs with civil legal remedies. We conducted a narrative review of peer-reviewed articles published between 2007 and 2022 to characterize the structure and impacts of US MLPs on patients, providers, and healthcare systems. We found that MLPs largely serve vulnerable patient populations by integrating legal experts into community-based clinical settings or children’s hospitals, although patient populations and settings varied widely. In most models, healthcare providers were trained to screen patients for legal needs and refer them to legal experts. MLPs provided a wide range of services, such as assistance accessing public benefits (e.g., Social Security, Medicaid, cash assistance) and legal representation for immigration and family law matters. Patients and their families also benefited from increased knowledge about legal rights and systems. Though the evidence base remains nascent, available studies show MLPs to be associated with greater access to care, fewer hospitalizations, and improved physical and mental health outcomes. Medical and legal providers who were engaged in MLPs reported interdisciplinary learning, and healthcare systems often experienced high returns on investment through cost savings and increased Medicaid reimbursement. Many MLPs also conducted advocacy and education to effect broader policy changes related to population health and social needs. To optimize the MLP model, more rigorous research, systematic implementation practices, evaluation metrics, and sustainable funding mechanisms are recommended. Broader integration of MLPs into healthcare systems could help address root causes of health inequity among historically marginalized populations in the USA.
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