Assessing the Value of Patient Navigation for Completing Cancer Screening
Assessing the Value of Patient Navigation for Completing Cancer Screening
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DOI：
10.1158/1055-9965.epi-12-0964
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发表时间：
2012-10-01
影响因子：
3.8
通讯作者：
Byers, Tim
中科院分区：
文献类型：
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作者：
Byers, Tim
1974年，在一家急诊医院完成医学培训后，我对医疗保健的看法主要是医生和护士在床上给人治病。然后我加入了印度卫生服务，很快就了解了社区卫生工作者的价值，比如社区卫生代表(CHR)，他们是引导美洲原住民和阿拉斯加原住民通过他们的医疗保健系统的非专业卫生工作者。如果没有CHRS在提供者和患者之间往往复杂的界面上做出的许多努力，我相信我们的健康结果将远远达不到许多患者的健康结果。尽管在其他临床环境中也有类似的患者导航位置，但在医疗服务提供者和患者之间的界面服务的非专业人员还不是美国医疗体系不可或缺的一部分。当然，一个原因是我们的医疗保健系统不是特别系统化，但另一个原因是我们还没有就患者导航员的价值达成共识。这两个障碍似乎都在让位。《平价医疗法案》定义了一个未来的医疗系统，它将更加以患者为中心，更有效地提供以证据为基础的干预措施，并对人群健康结果更负责；像本期CEBP上发表的研究将有助于定义我们医疗系统中患者导航器的价值(1，2)。
In 1974, after finishing medical training in an acute care hospital, my view of health care was largely that of doctors and nurses treating people in bed. Then I joined the Indian Health Service and quickly learned the value of community health workers such as the Community Health Representatives (CHR), who are lay health workers navigating Native Americans and Alaska Natives through their health care system. Without the many efforts of CHRs at the often-complex interface between providers and patients, I am sure our health outcomes would have fallen far short for many patients.Although similar patient navigation positions have developed in other clinical settings, lay workers serving at the interface between health care providers and patients are not yet an integral part of the US health care system. One reason, of course, is that our health care system is not particularly systematic, but another is that we have not yet achieved consensus about the value of patient navigators. Both of these barriers seem to be giving way. The Affordable Care Act defines a future health care system that is more patient centered, that delivers evidence-based interventions more effectively, and that is more accountable for population health outcomes; and research such as that published in this issue of CEBP will help to define the value of patient navigators within our health care system (1, 2).