集群诊所模式减少了获得医疗服务的旅行距离,提高了获得医疗服务的公平性

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
K. Johnstone , S. Turner
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引用次数: 0

摘要

旅行距离是获得医疗服务的一个障碍,特别是在人口稀少的大地区。集群诊所模式的目的是在格兰扁区国家医疗服务体系的社区环境中提供儿科定期护理。这项工作旨在量化该模型对旅行距离和平等访问的影响。研究设计:比较三种服务提供模式的观察性分析研究。方法比较三种模型:在皇家阿伯丁儿童医院分娩的所有诊所(模型A),在群集诊所分娩的所有诊所(模型B),以及在医院和群集诊所分娩的诊所(模型C)。计算了阿伯丁市和阿伯丁郡所有儿童从家到诊所的最短可驾驶距离。使用基尼系数来评估获取的公平性,接近0的值代表较好的公平性,1代表较差的公平性。结果在模型A中,出行距离中位数为8.64英里(Q1: 2.96英里,Q3: 25.7英里,基尼系数为0.491)。对于模型B,中位数行驶距离为3.14英里(Q1: 1.46英里,Q3: 9.07英里,基尼系数:0.480)。在模型C中,出行距离中位数为3.13英里(Q1: 1.35英里,Q3: 9.07英里,基尼系数:0.490)。在所有模型中均未发现与多重剥夺指数相关。结论集群诊疗模式在显著缩短就诊距离的同时,提高了就诊的公平性。应该考虑使用这种方法对其他地方类似模型的实现进行前瞻性评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cluster clinic model reduces travel distance to access care and improves access equality

Background

Travel distance is a barrier to accessing care, especially in large, sparsely populated areas. The cluster clinic model aims to provide paediatric scheduled care in the community setting within NHS Grampian. This work aims to quantify the impact of this model on travel distance and equality of access.

Study design

Observational analytical study comparing three models of service delivery.

Methods

Three models were compared: All clinics delivered at Royal Aberdeen Children's Hospital (model A), all clinics delivered at cluster clinics (model B), and clinics at both hospital and cluster clinics (model C). Shortest drivable distance from home to clinic was calculated for all children in Aberdeen City and Aberdeenshire. Equality of access was assessed using a Gini coefficient, with values closer to 0 representing better equality, and 1 representing worse equality.

Results

In model A, median travel distance was 8.64miles (Q1: 2.96miles, Q3: 25.7miles, Gini: 0.491). For model B, median travel distance was 3.14miles (Q1: 1.46miles, Q3: 9.07miles, Gini: 0.480). In model C, median travel distance was 3.13miles (Q1: 1.35miles, Q3: 9.07miles, Gini: 0.490). No association with index of multiple deprivation was found in any model.

Conclusions

The cluster clinic model both significantly reduces travel distance, whilst simultaneously improving access equality. This methodology should be considered to prospectively evaluate implementation of similar models elsewhere.
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来源期刊
Public Health in Practice
Public Health in Practice Medicine-Health Policy
CiteScore
2.80
自引率
0.00%
发文量
117
审稿时长
71 days
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