Providing continuity of care for chronic diseases in the aftermath of Katrina: from field experience to policy recommendations.
Providing continuity of care for chronic diseases in the aftermath of Katrina: from field experience to policy recommendations.
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DOI：
10.1097/dmp.0b013e3181b66ae4
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发表时间：
2009-10
影响因子：
2.7
通讯作者：
Icenogle ML
中科院分区：
文献类型：
--
作者：
Arrieta MI;Foreman RD;Crook ED;Icenogle ML
本研究旨在探讨卡特里娜飓风过后，亚拉巴马和密西西比沿海地区慢性病患者在医疗保健方面面临的挑战和解决方案。对30名卫生和社会服务提供者（关键信息提供者）和4个慢性病患者焦点小组进行了深入访谈。随后，召集了一个由主要知情人组成的咨询小组。对调查结果进行了总结，关键的举报人提交了补充反馈。被主要受访者确定为医疗管理优先事项的慢性病是精神健康、糖尿病、高血压、呼吸系统疾病、终末期肾病、心血管疾病和癌症。最常提到的提供护理的障碍是保持药物的连续性。促成因素是信息不足（无法获得医疗记录，患者知识不足）和财政限制。已实施或建议的解决办法包括：放宽保险限制，防止提前续药;加强灾前病人教育，以提高医疗知识;推广个人健康记录;支持社区保健中心的信息技术系统，特别是电子病历;改善捐赠药品/医疗用品的分配（集中协调，分散分配）;以及在地方应急人员和外部援助之间建立网络。
This study sought to elicit challenges and solutions in the provision of health care to those with chronic diseases after Hurricane Katrina in coastal Alabama and Mississippi. In-depth interviews with 30 health and social service providers (key informants) and 4 focus groups with patients with chronic diseases were conducted. Subsequently an advisory panel of key informants was convened. Findings were summarized and key informants submitted additional feedback. The chronic diseases identified as medical management priorities by key informants were mental health, diabetes mellitus, hypertension, respiratory illness, end-stage renal disease, cardiovascular disease, and cancer. The most frequently mentioned barrier to providing care was maintaining continuity of medications. Contributing factors were inadequate information (inaccessible medical records, poor patient knowledge) and financial constraints. Implemented or suggested solutions included relaxation of insurance limitations preventing advance prescription refills; better predisaster patient education to improve medical knowledge; promotion of personal health records; support for information technology systems at community health centers, in particular electronic medical records; improved allocation of donated medications/medical supplies (centralized coordination, decentralized distribution); and networking between local responders and external aid.