Vulnerable Populations in Hospital and Health Care Emergency Preparedness Planning: A Comprehensive Framework for Inclusion
Vulnerable Populations in Hospital and Health Care Emergency Preparedness Planning: A Comprehensive Framework for Inclusion
复制标题
DOI：
10.1017/s1049023x16000042
复制
发表时间：
2016-04-01
影响因子：
2.2
通讯作者：
Little, Charles
中科院分区：
文献类型：
--
作者：
Kreisberg, Debra;Thomas, Deborah S. K.;Little, Charles
简介：随着对应急准备的关注成为医疗机构运营规划的关键要素，全面认识和整合弱势群体需求的努力已经滞后。这不仅导致公平服务水平下降，而且影响灾难中医疗保健系统的运作。虽然本报告强调了美国的背景，但其概念和方法也适用于此背景之外。 目标：本报告：(1) 描述了一个概念框架，为将弱势群体纳入综合医疗保健和公共卫生准备提供了模型； (2) 将此模型应用于试点研究。方法：该框架源自文献、医院监管政策和医疗保健标准，列出了系统、组织和社区层面必须发生的沟通和关系界面，以实现成功的多层次医疗保健系统应对措施，明确包容不同人群。试点研究阐述了该框架关键要素的应用，采用四管齐下的方法，结合定量和定性方法来获取可为医院和卫生机构备灾规划提供信息的信息。结论：应用于试点项目的概念框架和模型指导扩展工作，最终可以形成方法上稳健的方法，将弱势群体全面纳入从地方到国家各级的医院备灾结构中，从而 支持社区防灾备灾方法的最佳实践。
Introduction: As attention to emergency preparedness becomes a critical element of health care facility operations planning, efforts to recognize and integrate the needs of vulnerable populations in a comprehensive manner have lagged. This not only results in decreased levels of equitable service, but also affects the functioning of the health care system in disasters. While this report emphasizes the United States context, the concepts and approaches apply beyond this setting.Objective: This report: (1) describes a conceptual framework that provides a model for the inclusion of vulnerable populations into integrated health care and public health preparedness; and (2) applies this model to a pilot study.Methods: The framework is derived from literature, hospital regulatory policy, and health care standards, laying out the communication and relational interfaces that must occur at the systems, organizational, and community levels for a successful multi-level health care systems response that is inclusive of diverse populations explicitly. The pilot study illustrates the application of key elements of the framework, using a four-pronged approach that incorporates both quantitative and qualitative methods for deriving information that can inform hospital and health facility preparedness planning.Conclusions: The conceptual framework and model, applied to a pilot project, guide expanded work that ultimately can result in methodologically robust approaches to comprehensively incorporating vulnerable populations into the fabric of hospital disaster preparedness at levels from local to national, thus supporting best practices for a community resilience approach to disaster preparedness.