The emergency department as a potential intervention recruitment venue among vulnerable rural residents.
The emergency department as a potential intervention recruitment venue among vulnerable rural residents.
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DOI：
10.1177/2150131910391534
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发表时间：
2011-04
影响因子：
3.6
通讯作者：
Bennett KL
中科院分区：
文献类型：
--
作者：
Tarasenko YN;Schoenberg NE;Bennett KL
满足农村居民的保健需求是复杂的，他们的巨大医疗负担往往超过病人和社区资源。这一点在阿巴拉契亚中部最为明显。由于病人和医疗服务提供者要处理更紧迫的医疗问题，预防性程序往往被牺牲。我们报告了一项试点研究的结果，旨在探讨放置在急诊科（艾德）的潜在干预措施的必要性和适当性，最终目标是使用艾德将传统上服务不足的患者与预防服务联系起来。我们使用了49名艾德患者的便利样本，以探讨他们的特征和健康需求，并将其与参加肯塔基州家园计划（KHP）的120名病例管理客户的样本和3，165名阿巴拉契亚州人的一般样本进行比较。招募的艾德患者具有较低的社会经济地位、多种健康状况和几种未满足的健康需求，包括需要进行结肠直肠癌、宫颈癌和乳腺癌筛查。与KHP相比，更多的艾德患者没有保险。艾德和KHP组的参与者收入特别低，受教育程度较低，保险覆盖率低于平均阿巴拉契亚居民。尽管包括KHP在内的病例管理服务成功地增加了有需要的人获得保健的机会，但某些人口群体仍然得不到充分的服务，继续被这些方案所遗漏。我们的研究表明，有必要和适当的接触到这些服务不足的人群在艾德，并让他们参与到潜在的干预措施，旨在加强预防性卫生服务。
Meeting the health care needs of rural residents is complicated by their substantial medical burdens that frequently outstrip patient and community resources. Nowhere is this more evident than in central Appalachia. Preventive procedures are often sacrificed as patients and providers attend to more pressing medical issues. We report the results of a pilot study designed to explore the need for and appropriateness of a potential intervention placed in an emergency department (ED), with the eventual goal of using the ED to link traditionally underserved patients to preventive services. We used a convenience sample of 49 ED patients to explore their characteristics and health needs and compare them with a sample of 120 case management clients participating in the Kentucky Homeplace Program (KHP), and a general sample of 3,165 Appalachian Kentuckians. The recruited ED patients had low socio-economic status, numerous health conditions, and several unmet health needs, including need for colorectal, cervical, and breast cancer screening. Compared to their KHP counterparts, more ED patients were uninsured. Participants in the ED and KHP groups had particularly low income, were less educated, and had less insurance coverage than an average Appalachian resident. Although case management services, including the KHP, have been successful in increasing access to health care by those in need, certain segments of the population remain underserved and continued to be missed by such programs. Our study suggests the need for and appropriateness of reaching out to such underserved populations in the ED and involving them into potential interventions designed to enhance preventive health services.