Taylor Riley , Rachel Umoren , Annabelle Kotler , John Feltner , Zeenia Billimoria , Jasmine James , Adithi Mahankali , Cailin White , Ivana Brajkovic , Megan M. Gray
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引用次数: 0
Abstract
Introduction
The disproportionate distribution of healthcare resources in the U.S. leads to an annual estimated 68,000 critically-ill newborns transported to regional centers for intensive care. As described in the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 framework, patients with limited access to healthcare experience multiple healthcare settings in their journey to specialty care. Little is known about community resources for transported neonatal patients in the Pacific Northwest region.
Methods
Transport data from January 2014–December 2019 identified referral zip codes for transfers to a regional neonatal intensive care unit (NICU). Using the SEIPS 3.0 framework to explore the journey of families experiencing neonatal complications, we linked referral zip codes to data on healthcare and resource access including: Health Transportation Shortage Index (HTSI); US Census Small Area Income and Poverty Estimates; public transportation availability; Health Professional Shortage Area (HPSA) and number of Federally Qualified Health Centers.
Results
1834 neonatal transports from 75 zip codes were analyzed. Forty percent of patients were transferred from a HPSA, one-quarter from areas with limited public transit availability (28%) and household internet access (24%). Almost all infants transferred from a high HTSI area (96%) were transported by air.
Conclusion
Many patients were referred from communities with high poverty and limited services. Improving patient outcomes requires population and policy level recommendations and care coordination between healthcare organizations and community services. Considering the patient family perspective within the SEIPS 3.0 framework will ensure patient centered care and an inclusive experience for families transitioning through healthcare settings.
期刊介绍:
The journal publishes original contributions that add to our understanding of the role of humans in today systems and the interactions thereof with various system components. The journal typically covers the following areas: industrial and occupational ergonomics, design of systems, tools and equipment, human performance measurement and modeling, human productivity, humans in technologically complex systems, and safety. The focus of the articles includes basic theoretical advances, applications, case studies, new methodologies and procedures; and empirical studies.