Using Public-Private Partnerships to Mitigate Disparities in Access to Genetic Services: Lessons from Wisconsin.
Using Public-Private Partnerships to Mitigate Disparities in Access to Genetic Services: Lessons from Wisconsin.
复制标题
利用公私合作伙伴关系减少获取遗传服务方面的差异：威斯康星州的经验教训。
DOI：
10.1108/s1057-629020150000016010
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Orne,Jason
中科院分区：
文献类型：
--
作者：
Senier,Laura;Kearney,Matthew;Orne,Jason
PurposeThis混合方法的研究报告外展诊所计划，旨在提供遗传服务的医疗服务不足的社区在威斯康星州。方法/approachWe显示的地理分布，资金模式，和利用趋势外展诊所在20年的时间。对项目规划者和外展诊所工作人员的采访表明，外部和内部的限制是如何限制项目的能力的。我们比较诊所业务的概念模型指导程序design.FindingsOur的研究结果表明，国家卫生官员不得不缩减财政支持外展诊所活动，而医疗服务提供者面临越来越大的压力，从管理人员减少在慈善护理的投资。这些外部和内部的制约因素导致接受服务的病人总数下降。我们还发现，诊所重新分配到密尔沃基地区增加了西班牙裔美国人的利用率，但不是非洲裔美国人。我们的采访表明，这些模式可能是一个功能的缺陷嵌入在规划models.Research/Policy ImplicationsPlanning模型有三个缺点。首先，它们没有将减少健康差距确定为一项具体目标。其次，他们没有认识到，合作伙伴面临着不断升级的逐利任务，这可能会限制他们提供慈善服务的能力。最后，他们underemphasize寻求值得信赖的合作伙伴的重要性，特别是在与社区的工作，在历史上被边缘化。独创性/ValueThere一直很少讨论aboutequitablyleveraging遗传进步，提高医疗质量和疗效。在社会学文献中，国家卫生机构在减少获得遗传服务方面的差距方面的作用在很大程度上被忽视。
PurposeThis mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.Methodology/approachWe show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.FindingsOur findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.Research/Policy ImplicationsPlanning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.Originality/ValueThere has been little discussion aboutequitablyleveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.
登录
查看更多内容
“新”遗传学与旧下层阶级的相遇：肯塔基州农村遗传推广服务研究的结果
影响因子：
2.8
作者：
S. Kelly
通讯作者：
S. Kelly
临床遗传学服务的组织和提供。
影响因子：
2.6
作者：
B. Bernhardt;R. Pyeritz
通讯作者：
R. Pyeritz
影响因子：
5.2
作者：
Ford, EW;Duncan, WJ;Ginter, PM
通讯作者：
Ginter, PM
影响因子：
9.7
作者：
Weissman, JS;Moy, E;Blumenthal, D
通讯作者：
Blumenthal, D
如何制定和实施癌症遗传学风险评估计划
DOI：
--
发表时间：
2004
期刊：
影响因子：
--
作者：
Christopher Ho
通讯作者：
Christopher Ho