了解学生开办的免费诊所的初级保健经验

Salmaan Kamal, April E. Hoge, Aerin Derussy, E. Austin, D. Pollio, A. Montgomery, S. Kertesz
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引用次数: 0

摘要

背景:美国有100多家学生开办的免费诊所,通常为没有保险的人群提供服务。到目前为止,还没有将患者报告的SRFC初级保健经验与为类似人群服务的主流初级保健诊所的初级保健经验进行比较。在这项研究中,我们调查了伯明翰平等准入中心(EAB)的患者,并将我们的结果与两家为无家可归者提供服务的PC诊所的结果进行了比较。方法:我们采用经验证的“无家可归者初级保健质量”调查对60名EAB患者进行了调查。它生成了一个总分和4个分量表得分(临床医生-患者关系、感知的提供者间合作、可及性/协调、无家可归者的特殊需求)。我们将EAB的评分与退伍军人事务部(VA)主流PC诊所(n=150)和无家可归者定制的非退伍军人事务部无家可归者医疗保健计划(HCH)(n=195)的评分进行了比较。结果:EAB的评分与主流VA诊所的评分相似(p>0.05)。EAB在每个分量表中的得分都低于无家可归者定制的非VA HCH项目,尽管差异没有统计学意义。EAB患者最常称赞工作人员的人际交往能力。超过25%的受访者给出负面评价的项目涉及等待时间(29%)、护理协调(65%)和对提供者技能的看法(43%)。结论:尽管资源有限,SRFC的得分与主流VA PC环境相当。SRFC将在照顾没有保险的个人方面发挥持续的作用,虽然这些数据表明SRFC患者的体验大多是有利的,但可能需要额外的资源来接近为无家可归者量身定制的诊所所获得的护理体验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Understanding the Primary Care Experience in a Student-Run Free Clinic
Background: Over 100 student-run free clinics (SRFCs) operate in the United States (US), typically serving uninsured populations. To date, there has been no effort to compare the patient-reported primary care experience in SRFCs to those of mainstream primary care (PC) clinics serving similar populations. In this study, we surveyed patients at Equal Access Birmingham (EAB), an SRFC, and compared our results to those from two PC clinics serving homeless-experienced clientele. Methods: We surveyed 60 EAB patients with the validated “Primary Care Quality-Homeless” survey. It generates an overall score and 4 subscale scores (clinician-patient Relationship, perceived inter-provider Cooperation, Accessibility/Coordination, Homeless-Specific Needs). We compared EAB’s ratings to those published for a Veterans Affairs (VA) mainstream PC (n=150) clinic and a homeless-tailored non-VA Health Care for the Homeless (HCH) program (n=195). Results: EAB’s ratings were similar to those of the mainstream VA clinic (p>0.4). EAB scored lower than the homeless-tailored non-VA HCH program in each subscale, though the difference did not achieve statistical significance. EAB patients most often praised the staff’s interpersonal skills. Items in which >25% of respondents gave a negative rating concerned wait times (29%), coordination of care (65%), and perceptions of provider skill (43%). Conclusions: Despite constrained resources, an SRFC scored comparably to a mainstream VA PC setting. SRFCs will play a continuing role in care of uninsured individuals, and while these data suggest SRFC patient experiences are mostly favorable, additional resources may be required to approximate the care experience achieved in clinics tailored for homeless persons.
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