Patient navigation across the spectrum of women's health care in the United States.
Patient navigation across the spectrum of women's health care in the United States.
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DOI：
10.1016/j.ajog.2017.08.009
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发表时间：
2018-03
影响因子：
9.8
通讯作者：
Yee LM
中科院分区：
文献类型：
--
作者：
McKenney KM;Martinez NG;Yee LM
患者导航是一种以患者为中心的干预措施，使用经过培训的人员来识别患者层面的障碍，包括医疗保健的财务，文化，后勤和教育障碍，然后缓解这些障碍，以促进完整和及时地获得医疗服务。例如，为了帮助医疗补助患者寻求产后护理，患者导航员可以帮助她在保险福利变化之前安排预约，协调交通和儿童保育，给她避孕选择的信息小册子，并陪同她预约以确保她的问题得到回答。检查患者导航干预措施的有效性的现有研究显示，在癌症护理领域（包括妇科肿瘤学）中特别显着的益处;患者导航已被证明可以增加筛查的可及性，缩短诊断解决的时间，并改善癌症结局，特别是在健康差异人群中，如有色人种妇女，农村人口和贫困妇女。由于癌症护理在减少医疗服务和健康结果方面的差异方面取得了成功，患者导航有可能改善护理并减少产科和良性妇科护理的差异。我们回顾了病人导航的概念，提供了妇产科病人导航的潜在作用，并讨论了进一步研究的领域。
Patient navigation is a patient-centered intervention that uses trained personnel to identify patient-level barriers, including financial, cultural, logistical, and educational obstacles to health care, then mitigate these barriers to facilitate complete and timely access to health services. For example, in order to assist a Medicaid patient seeking postpartum care, a patient navigator could help her schedule an appointment before her insurance benefits change, coordinate transportation and childcare, give her informational pamphlets on contraception options, and accompany her to the appointment to ensure her questions are answered. Existing studies examining the efficacy of patient navigation interventions show particularly striking benefits in the realm of cancer care, including gynecologic oncology; patient navigation has been demonstrated to increase access to screening, shorten time to diagnostic resolution, and improve cancer outcomes, particularly in health disparity populations, such as women of color, rural populations, and poor women. Due to the successes in cancer care at reducing disparities in health care access and health outcomes, patient navigation has the potential to improve care and reduce disparities in obstetric and benign gynecologic care. We review the concept of patient navigation, offer potential roles for patient navigation in obstetrics and gynecology, and discuss areas for further investigation.
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