Health Care Access of Inner-City Children with Asthma

描述（由申请人提供）：本研究的目的是探索市中心哮喘儿童的访问模式，并确定当前的医疗保健系统如何促进或阻碍这一人群使用医疗保健资源。 本研究的具体目的是：1）识别促进或阻碍患者获得哮喘管理初级卫生保健的个体易感属性，2）识别促进或阻碍患者获得哮喘管理初级卫生保健的卫生保健系统的使能属性，以及3）检查患者主观体验和健康护理提供者客观体验的需求属性，这些属性触发了紧急，紧急，和初级卫生保健服务。 本研究设计将采用质性设计方法，以深入了解患者的经验;质性访谈将客观地与病历和卫生系统数据进行比较。 数据收集方法包括：半结构化访谈、焦点小组、哮喘严重程度测量、资源利用和人口统计学数据。 样本将包括寻求哮喘护理的儿童的父母和在城市医院和城市社区卫生诊所提供护理的卫生保健提供者。 这项研究的意义在于更好地了解市中心哮喘儿童独特的卫生保健利用模式。 查明促进或阻碍资源利用的属性将有助于重新设计系统和改变政策，以更好地解决这一弱势群体面临的获取障碍。

DESCRIPTION (provided by applicant): The purpose of this study is to explore the access patterns of inner-city children with asthma and to identify how current health care systems facilitate or impede the use of health care resources by this population. Specific aims of this study are to 1) identify the individual predisposing attributes that facilitate or impede patients from accessing primary health care for asthma management, 2) identify the enabling attributes of health care systems that facilitate or impede patient access to primary care for asthma management, and 3) examine the need attributes as subjectively experienced by patients and as objectively experienced by health care providers that trigger access to urgent, emergent, and primary health care services. Qualitative design methods will be employed in this research design in order to gain an in-depth understanding of patient experiences; qualitative interviews will be objectively compared with medical records and health system data. Data collection methods will include: semi-structured interviews, focus groups, asthma severity measures, resource utilization, and demographic data. The sample will include parents of children seeking asthma care and health care providers providing care in an urban hospital and in urban community health clinics. The significance of this study is to gain a better understanding the pattern of health care utilization unique to inner-city children with asthma. Identifying attributes that facilitate or impede resource utilization will allow system redesign and policy changes to better address the access barriers experienced by this vulnerable population.