Translating the Patient Navigator Approach to Meet the Needs of Primary Care
Translating the Patient Navigator Approach to Meet the Needs of Primary Care
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DOI：
10.3122/jabfm.2010.06.100085
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发表时间：
2010-11-01
影响因子：
2.9
通讯作者：
Crosson, Jesse C.
中科院分区：
文献类型：
--
作者：
Ferrante, Jeanne M.;Cohen, Deborah J.;Crosson, Jesse C.
背景资料：帮助患者应对复杂而分散的美国医疗保健系统并协调他们的护理是以患者为中心的医疗之家的核心。我们评估了试点使用的病人导航仪（PN），有人谁可以帮助患者有效地使用医疗保健系统，在primary care practices.Methods：本研究是一个跨案例的比较分析，4个社区的做法，实施病人导航。项目会议记录，PN活动日志和述职，医生访谈，病人/家庭成员访谈进行了分析，使用接地approach.Results：75大多是女性，老年患者从社会工作者接受导航服务。PN通常帮助患者获得社会服务，并浏览健康保险和复杂的转诊。PN工作区的可用性、与实践成员的互动以及用于选择和转诊患者的流程影响PN与实践的合作和整合。患者发现PN服务非常有帮助，和医生认为PN的人进行新的任务，实践是以前doing.Conclusions：患者导航社区初级保健的做法是有用的患者谁有复杂的需求。将这些服务整合到初级保健环境中将需要新的实践和支付模式，以充分发挥集成患者导航服务在这种环境中的潜力。（J Am Board Fam Med 2010;23：736-744.）
Background: Helping patients navigate the complex and fragmented US health care system and coordinating their care are central to the patient-centered medical home. We evaluated the pilot use of a patient navigator (PN), someone who helps patients use the health care system effectively and efficiently, in primary care practices.Methods: This study was a cross-case comparative analysis of 4 community practices that implemented patient navigation. Project meeting notes, PN activity logs and debriefings, physician interviews, and patient/family member interviews were analyzed using a grounded approach.Results: Seventy-five mostly female, elderly patients received navigation services from a social worker. The PN typically helped patients obtain social services and navigate health coverage and complex referrals. Availability of workspace for PN, interaction with practice members, and processes used for selecting and referring patients affected PN collaboration with and integration into practices. Patients found PN services very helpful, and physicians viewed the PN as someone carrying out new tasks that the practice was not previously doing.Conclusions: Patient navigation in community primary care practices is useful for patients who have complex needs. Integrating such services into primary care settings will require new practice and payment models to realize the full potential of integrated patient navigation services in this setting. (J Am Board Fam Med 2010;23:736-744.)