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Journal of Health Care for the Poor and Underserved最新文献

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Addressing Disparities in Access to Mechanical Thrombectomy in a Developing Country: Insights from a Public-Private Partnership in Colombia. 解决发展中国家在机械取栓方面的差距：来自哥伦比亚公私合作伙伴关系的见解。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a959120
Juan Diego Martínez-Lemus, Stefania Forero-Caldas, Annelise Velasco de Azevedo-Pereira, Andrea Del Pilar González-Gamboa, Neiry María Zapa-Pérez, Hernán Bayona-Ortiz, Claudio Alejandro Jiménez-Monsalve
{"title":"Addressing Disparities in Access to Mechanical Thrombectomy in a Developing Country: Insights from a Public-Private Partnership in Colombia.","authors":"Juan Diego Martínez-Lemus, Stefania Forero-Caldas, Annelise Velasco de Azevedo-Pereira, Andrea Del Pilar González-Gamboa, Neiry María Zapa-Pérez, Hernán Bayona-Ortiz, Claudio Alejandro Jiménez-Monsalve","doi":"10.1353/hpu.2025.a959120","DOIUrl":"https://doi.org/10.1353/hpu.2025.a959120","url":null,"abstract":"<p><strong>Introduction: </strong>Access to mechanical thrombectomy (MT) for ischemic stroke with large vessel occlusion is limited in upper middle-income countries.</p><p><strong>Objective: </strong>To describe the experience of a public-private partnership (PPP) aimed at enhancing MT access in Bogotá, Colombia's public health care network.</p><p><strong>Methods: </strong>Cross-sectional study describes access to MT under two drip-and-ship referral models (model A and B). Bivariate analysis was conducted using SPSS V25.</p><p><strong>Results: </strong>Between 2021 and 2023, there were 116 MT code activations. Over sixty percent (61.6%) successfully accessed MT, while administrative barriers prevented access in the remaining cases. There was no significant difference in MT access between PPP models A (60%) and B (66.7%). Model B faced prominent administrative issues related to insurance.</p><p><strong>Conclusions: </strong>Public-private partnerships significantly improved MT access in Bogotá, benefiting nearly two-thirds of the studied population. However, administrative challenges persist. Effective referral systems and robust national policies are crucial for further enhancing MT access.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 2","pages":"670-684"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Obstetrics and Gynecology Residency Training on Caring for Incarcerated Patients: A National Survey of Programs. 关于监禁病人护理的妇产科住院医师培训：一项全国项目调查。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a959118
Meghna Tummala, Erin Christine Brousseau
{"title":"Obstetrics and Gynecology Residency Training on Caring for Incarcerated Patients: A National Survey of Programs.","authors":"Meghna Tummala, Erin Christine Brousseau","doi":"10.1353/hpu.2025.a959118","DOIUrl":"https://doi.org/10.1353/hpu.2025.a959118","url":null,"abstract":"<p><p>Reproductive health needs of incarcerated individuals are complex due to multiple forms of structural oppression, but little is known about the present state of obstetrics and gynecology (Ob/Gyn) resident training on providing reproductive health care to this rapidly growing population. Through this cross-sectional study, program leaders at all United States Ob/Gyn residency programs were emailed a survey in 2022. Among respondent programs (response rate of 38%), 81% have opportunities for residents to see incarcerated patients in a clinical setting, but only 23% have mandatory didactic content on caring for this population. There is a glaring gap in Ob/Gyn resident education on caring for incarcerated patients, even though residents are actively treating these patients. Furthermore, although most program leaders believe that training residents to care for this population is important, programs are not equipped to do so because of various barriers, including limited faculty expertise and competing educational requirements.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 2","pages":"644-656"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility of Medical-Legal Partnership to Improve Inpatient Outcomes and Reduce Hospital Length of Stay. 医法伙伴关系改善住院治疗效果和缩短住院时间的可行性。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a959105
Nicole DePolo, Catherine A West, Brian D Johnston
{"title":"Feasibility of Medical-Legal Partnership to Improve Inpatient Outcomes and Reduce Hospital Length of Stay.","authors":"Nicole DePolo, Catherine A West, Brian D Johnston","doi":"10.1353/hpu.2025.a959105","DOIUrl":"https://doi.org/10.1353/hpu.2025.a959105","url":null,"abstract":"<p><strong>Introduction: </strong>Length of stay (LOS) is an important quality metric often affected by social determinants of health including health-harming legal needs (HHLNs). We sought to determine the feasibility of medical-legal partnerships (MLPs) in the inpatient setting to improve LOS.</p><p><strong>Methods: </strong>Adult patients admitted to a safety-net public hospital beyond medically predicted LOS (n=110) were assessed for HHLNs via chart review and standardized surveys then referred for legal intervention if indicated. Staff were surveyed regarding HHLNs and MLPs. Retrospective cost-analysis was performed one year later.</p><p><strong>Results: </strong>Average excess LOS days were 41±51, and HHLNs were identified among 69% of patients. The need for guardianship was specifically associated with increased excess LOS (p=.03). Staff reported interest in MLPs, and referrals increased after initial exposure. Cost-analysis at one year showed savings in excess of $200,000.</p><p><strong>Conclusions: </strong>Medical-legal partnerships have potential to reduce excess LOS, improving inpatient clinical outcomes and health care cost-effectiveness.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 2","pages":"417-426"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Case Study of Community Dental Health Coordinator: Evaluating a Medical-Dental Collaboration to Address Barriers to Preventive Dental Care. 社区牙科健康协调员的案例研究：评估医疗-牙科合作以解决预防牙科保健的障碍。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a951585
Jessica Weisz, Desiree de la Torre, Anupama Rao Tate
{"title":"A Case Study of Community Dental Health Coordinator: Evaluating a Medical-Dental Collaboration to Address Barriers to Preventive Dental Care.","authors":"Jessica Weisz, Desiree de la Torre, Anupama Rao Tate","doi":"10.1353/hpu.2025.a951585","DOIUrl":"10.1353/hpu.2025.a951585","url":null,"abstract":"<p><strong>Background: </strong>Tooth decay is common, but low-income families have low rates of preventive oral health care. The American Dental Association community dental health coordinator (CDHC) model has successfully increased referrals to co-located dentists.</p><p><strong>Objective: </strong>To implement a CDHC to link families between the medical home and community dentists.</p><p><strong>Methods: </strong>The CDHC universally screened patients between 2-17 years of age during medical check-ups at two sites. Iterative plan-do-study-act (PDSA) cycles aim to increase screening, increase participants, and increase phone follow-up with families. When participation was low, family and provider focus groups were held.</p><p><strong>Results: </strong>The CDHC completed 2,933 intakes with 745 appointments made and 250 dental appointments attended. Focus group participants of patients and providers endorsed support for the program, but iterative PDSA cycles did not increase participation.</p><p><strong>Discussion: </strong>The generalizability of the CDHC model from referrals to internal, co-located dentists to external, community providers was not as successful as expected.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"67-74"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Community Health Centers and Medical Traineeship Patterns-Implications for Addressing Health Workforce Shortage. 社区卫生中心和医疗培训模式——解决卫生人力短缺的意义。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a951592
Seongwon Choi, Aizhan Karabukayeva, Ganisher Davlyatov, William Opoku-Agyeman
{"title":"Community Health Centers and Medical Traineeship Patterns-Implications for Addressing Health Workforce Shortage.","authors":"Seongwon Choi, Aizhan Karabukayeva, Ganisher Davlyatov, William Opoku-Agyeman","doi":"10.1353/hpu.2025.a951592","DOIUrl":"10.1353/hpu.2025.a951592","url":null,"abstract":"<p><p>This study explores medical training programs within community health centers (CHCs) and investigates the organizational and environmental factors associated with these programs. Using cluster analysis, we identified four distinct clusters based on the prevalence of physician, nurse, advanced practitioner, and medical assistant trainees in CHCs. These clusters reveal variations in the composition of trainees within CHCs, indicating diverse training and recruitment priorities. Our analysis of organizational and environmental correlates found significant associations between factors such as urban location, CHC size, and the percentage of other clinical trainee types with the distribution of clinical trainees. The insights gained from this study are crucial for advancing the ongoing development of CHC medical training programs, emphasizing the delivery of high-quality primary care, comprehensive training, and education while addressing workforce challenges in resource-limited settings.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"180-191"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient Navigation in Amyotrophic Lateral Sclerosis (ALS): A Potential Approach to Timely Diagnosis. 肌萎缩侧索硬化症（ALS）患者导航：一种及时诊断的潜在方法。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a951602
Busisiwe Mombaur, Kaiseree Dias
{"title":"Patient Navigation in Amyotrophic Lateral Sclerosis (ALS): A Potential Approach to Timely Diagnosis.","authors":"Busisiwe Mombaur, Kaiseree Dias","doi":"10.1353/hpu.2025.a951602","DOIUrl":"10.1353/hpu.2025.a951602","url":null,"abstract":"<p><p>Amyotrophic lateral sclerosis (ALS) poses challenges for timely diagnosis due to its protean early manifestations and lack of definitive tests. This article explores how patient navigation interventions can expedite diagnosis, particularly for underserved patients who face disproportionately longer delays. Patient navigation has proven effective in reducing disparities in various diseases by providing guidance and support to patients and caregivers. It enhances awareness, facilitates communication with health care providers, and streamlines diagnosis. Drawing from literature on patient navigation in other diseases, this article proposes tailored adaptations for ALS diagnosis and addresses potential implementation barriers and strategies to overcome them. Integrating patient navigation into the ALS diagnostic pathway holds promise for improving efficiency, optimizing outcomes, and reducing health care disparities among underserved populations.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"361-374"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frostbite Injuries in Chicago's Unsheltered Population. 芝加哥无家可归人口的冻伤。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a951597
Owen Lewer, Cassandra Singler, Emily Wong, Danielle McGinnis, Theresa Nguyen
{"title":"Frostbite Injuries in Chicago's Unsheltered Population.","authors":"Owen Lewer, Cassandra Singler, Emily Wong, Danielle McGinnis, Theresa Nguyen","doi":"10.1353/hpu.2025.a951597","DOIUrl":"10.1353/hpu.2025.a951597","url":null,"abstract":"<p><p>People experiencing unsheltered homelessness (PEUH) have an increased risk of frostbite injury, which can be a dangerous and debilitating condition. Our study aims to determine the prevalence, incidence, and impact of frostbite in the unsheltered population in Chicago and nearby suburbs. We administered a survey at a Chicago Transit Authority metro station in suburban Cook County to assess the frequency of frostbite injury and the circumstances surrounding frostbite in this community. Our results demonstrated that frostbite is both common (incidence rate (IR) =1271.67 cases of frostbite per 100,000 life-years (LY)) and highly morbid (IR=46.24 amputations per 100,000 LY) in PEUH in Chicago. We hope to include more street medicine partners to raise awareness about the impact of frostbite injury in the unsheltered population and advocate for improved emergency preparedness plans during the cold winter season.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"284-294"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What is Unspoken: The Discomfort Experienced by Pediatric Resident Physicians Delivering Racially Discordant Clinical Care. 什么是不言而喻的：儿科住院医师在提供种族不和谐的临床护理时所经历的不适。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a951593
Sabrina M Darwiche, Anda K Kuo, Christine Schudel, Maya Morales, Helen Iat Chio Chan, Dayna Long
{"title":"What is Unspoken: The Discomfort Experienced by Pediatric Resident Physicians Delivering Racially Discordant Clinical Care.","authors":"Sabrina M Darwiche, Anda K Kuo, Christine Schudel, Maya Morales, Helen Iat Chio Chan, Dayna Long","doi":"10.1353/hpu.2025.a951593","DOIUrl":"10.1353/hpu.2025.a951593","url":null,"abstract":"<p><p>A diverse physician workforce is imperative to addressing health inequities, but few physicians identify as Black or Hispanic. Therefore, this study used the social constructionism framework to explore pediatric residents' perceptions of race in medical encounters. A qualitative study of 47 trainees at a tertiary care center revealed the following: (1) racism, not race, influences health; (2) trainee perceptions around race create feelings of discomfort during some racially discordant patient encounters, while they were a source of comfort for trainees of color during concordant encounters; and (3) trainee perceptions around race in racially discordant clinical encounters may result in a change in clinical practice. While participants expressed awareness that racism drives health disparities, they had limited understanding of how their interactions might further perpetuate disparate health outcomes for patients of color. This emphasizes the need to support anti-racism competencies in medical education and increase workforce diversity in health care.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"192-208"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment Of A Health System-Integrated Children's Savings Account and Financial Coaching Program Serving Low-Income Moms and Babies in Texas. 评估卫生系统整合的儿童储蓄账户和财务指导计划，为低收入的母亲和婴儿在德克萨斯州。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a951584
Todd A Olmstead, Laura Rosen, Michael K Hole
{"title":"Assessment Of A Health System-Integrated Children's Savings Account and Financial Coaching Program Serving Low-Income Moms and Babies in Texas.","authors":"Todd A Olmstead, Laura Rosen, Michael K Hole","doi":"10.1353/hpu.2025.a951584","DOIUrl":"10.1353/hpu.2025.a951584","url":null,"abstract":"<p><p>Families living in poverty with young children are particularly vulnerable to poor health outcomes. This study used a randomized controlled trial to analyze the impact of Early Bird (EB), a novel health system-integrated program that provided financial incentives to low-income mothers for achieving healthy milestones. Participants randomized to the EB condition received contributions in a tax-advantaged children's savings account (CSA) for attending a maternal six-week postpartum check-up ($25), a pediatric dental visit by age 12 months ($75), six well-check visits by age 15 months ($75), two financial coaching sessions ($30), and enrolling in the EB program and opening a CSA ($250). We found that Early Bird increased the likelihood that mothers attended a financial coaching session. We found no evidence of an increase in the likelihood of completing any of the medical milestones. Future work should examine whether larger contributions to CSAs might incentivize mothers to achieve the medical milestones.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 1","pages":"56-66"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Workplace Violence in Health Care: An Overdue OSHA Standard in the Making. 医疗保健中的工作场所暴力：一项迟来的OSHA标准正在制定中。
IF 1.2 4区 医学
Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI: 10.1353/hpu.2025.a959123
Eli Y Adashi, Daniel P O'Mahony, I Glenn Cohen
{"title":"Workplace Violence in Health Care: An Overdue OSHA Standard in the Making.","authors":"Eli Y Adashi, Daniel P O'Mahony, I Glenn Cohen","doi":"10.1353/hpu.2025.a959123","DOIUrl":"https://doi.org/10.1353/hpu.2025.a959123","url":null,"abstract":"<p><p>The evidence of rising workplace violence in the health care sector is clear. Two recent surveys (of emergency physicians and nursing personnel) indicate that the rate of violence experienced by health care workers has increased, and the number of assaults is alarming. Workplace violence also a is a key compounder of staff attrition as well as patient safety. Absent federal protective legislation, OSHA (Occupational Safety and Health Administration) has developed a potential standard for the prevention of workplace violence in health care and social assistance.</p>","PeriodicalId":48101,"journal":{"name":"Journal of Health Care for the Poor and Underserved","volume":"36 2","pages":"715-719"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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