Assessing Alignment of Patient and Clinician Perspectives on Community Health Resources for Chronic Disease Management.
Assessing Alignment of Patient and Clinician Perspectives on Community Health Resources for Chronic Disease Management.
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DOI：
10.3390/healthcare10102006
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发表时间：
2022-10-12
期刊：
影响因子：
2.8
通讯作者：
Lyles, Courtney R.
中科院分区：
文献类型：
--
作者：
Potharaju, Kameswari A.;Fields, Jessica D.;Cemballi, Anupama G.;Pantell, Matthew S.;Desai, Riya;Akom, Antwi;Shah, Aekta;Cruz, Tessa;Nguyen, Kim H.;Lyles, Courtney R.
关键词：
解决健康的社会决定因素 (SDoH) 与改善安全网环境中慢性病患者的临床结果相关。这项定性研究辅以描述性定量分析，调查了患者和临床医生对旧金山公共医疗保健服务系统内的 SDoH 资源和诊所转诊的看法之间的一致性程度。我们对 10 名患者和 7 名初级保健临床医生的深度访谈、患者主导的社区参观以及亲自诊所访问观察进行了定性分析。使用收敛并行混合方法，我们还完成了描述性定量分析，将患者或社区领导提到的社区卫生资源类别与集成到电子健康记录中的资源进行比较。我们发现，患者对与 SDoH 相关的社区资源拥有丰富的知识，这些知识高度本地化且针对其社区。此外，多个利益相关者参与了 SDoH 筛查和转介，包括临床医生、系统导航员（例如案例工作者）和社区组织。然而，这些利益相关者和患者之间的信息流缺乏系统化，患者和临床医生对社会需求的优先顺序不一致，这表现为定性主题以及资源类别分布分析中的定量差异（p < 0.001）。我们的结果揭示了通过改善患者参与、诊所工作流程、电子病历参与和资源传播来加强安全网医疗保健环境中的社会护理服务的机会。
Addressing social determinants of health (SDoH) is associated with improved clinical outcomes for patients with chronic diseases in safety-net settings. This qualitative study supplemented by descriptive quantitative analysis investigates the degree of alignment between patient and clinicians’ perceptions of SDoH resources and referrals in clinics within the public healthcare delivery system in San Francisco. We conducted a qualitative analysis of in-depth interviews, patient-led neighborhood tours, and in-person clinic visit observations with 10 patients and 7 primary care clinicians. Using a convergent parallel mixed methodology, we also completed a descriptive quantitative analysis comparing the categories of neighborhood health resources mentioned by patients or community leaders to the resources integrated into the electronic health record. We found that patients held a wealth of knowledge about neighborhood resources relevant to SDoH that were highly localized and specific to their communities. In addition, multiple stakeholders were involved in conducting SDoH screenings and referrals, including clinicians, system navigators such as case workers, and community-based organizations. Yet, the information flow between these stakeholders and patients lacked systematization, and the prioritization of social needs by patients and clinicians was misaligned, as represented by qualitative themes as well as quantitative differences in resource category distribution analysis (p < 0.001). Our results shed light upon opportunities for strengthening social care delivery in safety-net healthcare settings by improving patient engagement, clinic workflow, EHR engagement, and resource dissemination.
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影响因子：
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影响因子：
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