医生工作量减弱了精神卫生保健工作量对社区健康结果的影响:对分配提供者工作量的影响。

IF 1.8 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Gregory J Privitera, James J Gillespie, Arpitha Pamula, Brooke J Piper
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引用次数: 0

摘要

众所周知,医生的工作量会影响提供者的福祉和个别病人的遭遇,但对提供者的可用性如何影响更广泛的社区健康结果了解较少。初级保健医生(pcp)往往是事实上的精神卫生提供者,特别是在服务不足的社区。本研究评估了PCP和心理健康提供者工作量(通过提供者与居民的比率来衡量)是否能预测人群水平的身心健康结果。采用两种路径分析模型对来自2024年Robert Wood Johnson基金会县健康排名数据集(N = 3142个县)的县级数据进行分析;这些模型用于同时估计多个预测因子和结果之间的直接和间接关系。预测变量包括医疗服务提供者比例、未投保百分比(中介)和自我报告的身心不健康天数(结果)。更高的PCP工作量与更多的身体和心理健康状况不佳的天数显著相关。心理健康提供者比例与两种结果均无直接关系。未投保人群的间接影响也很显著,尤其是对身体健康的影响。这些发现表明,pcp在社区层面塑造心理和身体健康方面发挥了不成比例的作用。分析支持以下结论,即解决提供者短缺问题和改善保险覆盖范围可以改善健康结果,特别是当这些努力被纳入协作护理模式时,这种模式可以在提供者之间分配工作量,并使治疗方法与所服务人群的不同心理社会和医疗需求保持一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Physician Workload Attenuates the Impact of Mental Health Care Workload on Community Health Outcomes: Implications for Distributing Provider Workload.

Physician workload is known to impact provider well-being and individual patient encounters, but less is understood about how provider availability affects broader community health outcomes. Primary care physicians (PCPs) often serve as de facto mental health providers, particularly in underserved communities. This study evaluated whether PCP and mental health provider workload, measured by provider-to-resident ratios, predict population-level physical and mental health outcomes. County-level data from the 2024 Robert Wood Johnson Foundation County Health Rankings dataset (N = 3142 counties) were analyzed using two path analysis models; such models are used to estimate both direct and indirect relationships among multiple predictors and outcomes simultaneously. Predictor variables included provider ratios, percent uninsured (mediator), and self-reported physically and mentally unhealthy days (outcomes). Higher PCP workload was significantly associated with greater numbers of poor physical and mental health days. Mental health provider ratios were not directly associated with either outcome. Indirect effects through the percent uninsured were also significant, particularly for physical health outcomes. These findings suggest that PCPs play a disproportionate role in shaping both mental and physical health at the community level. The analysis supports the conclusion that addressing provider shortages and improving insurance coverage can enhance health outcomes, particularly when efforts are integrated into collaborative care models that distribute workload across providers and align treatment approaches with the diverse psychosocial and medical needs of the populations they serve.

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来源期刊
Population Health Management
Population Health Management 医学-卫生保健
CiteScore
4.10
自引率
4.00%
发文量
81
审稿时长
6-12 weeks
期刊介绍: Population Health Management provides comprehensive, authoritative strategies for improving the systems and policies that affect health care quality, access, and outcomes, ultimately improving the health of an entire population. The Journal delivers essential research on a broad range of topics including the impact of social, cultural, economic, and environmental factors on health care systems and practices. Population Health Management coverage includes: Clinical case reports and studies on managing major public health conditions Compliance programs Health economics Outcomes assessment Provider incentives Health care reform Resource management Return on investment (ROI) Health care quality Care coordination.
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