Doctoral Dissertation Research: Short-Term Health Care Providers and Network Structure

博士论文研究：短期医疗保健提供者和网络结构

• 批准号: 1357034
• 负责人: Clarence Gravlee
• 金额: $ 2.31万
• 依托单位: University of Florida
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1357034&HistoricalAwards=false
• 关键词: Doctoral; Dissertation; Research; Short; Term

University of Florida doctoral student Jessica-Jean Casler, supervised by Dr. Clarence C. Gravlee, will explore how networks of health care access and delivery are shaped by programs designed to improve the relationship between patient and provider. The research will focus on the role of short-term health care providers (STHPs). Short-term health care providers (such as medical school student brigades) supplement local and state health care services in many lower-income countries. Even with these additional providers however; the inability to access adequate health care largely continues to affect the poor. Annual influxes of short-term health care providers in lower-income countries suggest that health care systems may be changing structurally and with them the ways that patients and providers use health care services. This study will provide a timely contribution to this global issue by examining: (1) how patients and providers use short-term health care providers (STHPs), (2) whether the informal structure of providers? networks resemble patient networks, and (3) the role of STHPs in patients? health care networks. To meet these goals, the Co-PI will recruit 30 households in Matagalpa, Nicaragua representative of the socioeconomic, familial, and geographic diversity in the city to participate in the study. The site itself is chosen because of the high concentration of American medical students that visit it during an STHP trip. Households will be visited bi-monthly over a period of eight months as Ms. Casler the researcher conducts in-depth ethnographic interviews with her participants and also records their most recent usage of health care services. The Co-PI will map and interview all local health care providers (as identified by the community), collecting information about how they refer patients to different health care providers within the system. Using this information the Co-PI will be able to create network usage patterns for both patients and providers, determining any similarities between the networks and identifying the role of STHPs in one of Nicaragua?s urban health care systems. This research is important because it will contribute to the development of theory in both medical anthropology and the anthropology of development by mapping patients' and providers' use of health care providers within larger health care networks in a local setting. This study specifically explores the relatively recent addition of STHPs to health care systems of the poor and will also contribute to interdisciplinary social science research on health care systems. Findings will also suggest how urban health care systems could more efficiently use and organize the providers that typically comprise them. The project also supports the training of a graduate student.

佛罗里达大学博士生卡西卡-让·卡斯勒，由克拉伦斯·C·卡斯勒博士指导。Gravlee将探讨如何通过旨在改善患者和提供者之间关系的计划来塑造医疗保健获取和提供网络。该研究将侧重于短期医疗保健提供者（STHP）的作用。在许多低收入国家，短期保健提供者（如医学院学生队）补充地方和州的保健服务。然而，即使有了这些额外的提供者，穷人仍然无法获得充分的保健服务。低收入国家每年涌入的短期医疗保健提供者表明，医疗保健系统可能正在发生结构性变化，患者和提供者使用医疗保健服务的方式也随之发生变化。这项研究将提供一个及时的贡献，这一全球性问题，通过检查：（1）患者和提供者如何使用短期卫生保健提供者（STHP），（2）是否提供者的非正式结构？网络类似于患者网络，（3）STHP在患者中的作用？医疗保健网络。为了实现这些目标，Co-PI将在尼加拉瓜的马塔加尔帕招募30户代表该市社会经济、家庭和地理多样性的家庭参与研究。该网站本身是选择，因为高度集中的美国医学生访问它在一个STHP之旅。在为期八个月的时间里，研究人员Casler女士将每两个月访问一次家庭，对参与者进行深入的人种学访谈，并记录他们最近使用保健服务的情况。Co-PI将绘制地图并采访所有当地医疗保健提供者（由社区确定），收集有关他们如何将患者转介给系统内不同医疗保健提供者的信息。利用这些信息的共同PI将能够创建网络使用模式的患者和供应商，确定网络之间的任何相似之处，并确定在尼加拉瓜？城市卫生保健系统。 这项研究很重要，因为它将有助于医学人类学和发展人类学理论的发展，通过绘制患者和提供者在当地较大的医疗保健网络中使用医疗保健提供者的地图。这项研究专门探讨了相对较新的STHP的穷人的医疗保健系统，也将有助于跨学科的社会科学研究的医疗保健系统。研究结果还将表明城市医疗保健系统如何更有效地利用和组织通常包括它们的提供者。该项目还支持培训一名研究生。