Diversity, equity and inclusiveness in healthcare: A primary care perspective.

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2024-07-03 DOI:10.1111/jep.14073
Scott Worman
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Abstract

Addressing Diversity, Equity and Inclusion in health care is a multidimensional challenge. From a US perspective, the third-party payment system has disempowered and depersonalized health-care delivery. The net result is wasteful and inefficient use of human and financial resources, burnout among providers, as well as care inequities. Financial integration at the point of patient care is essential to aligning the needs of patients with advances in medical technology. Complexity theory offers valuable insights into the roles of government, intermediaries and patients. The government must focus on equity as a rule compiler and referee of the system. Patient and providers who are actively engaged in shared decision-making will naturally address the diverse needs of multitudinous communities. Intermediaries address inclusion by connecting resources with the point of care. In a dynamic, emerging health-care system that serves diverse communities, patient and community-based financing, vouchers and defined contributions are necessary first steps in addressing cultural diversity, inclusion and equity.

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医疗保健的多样性、公平性和包容性:初级保健视角。
解决医疗保健领域的多样性、公平性和包容性问题是一项多层面的挑战。从美国的角度来看,第三方支付系统削弱了医疗服务的权力,使其失去了个性化。其最终结果是人力和财力资源的浪费和低效利用、医疗服务提供者的职业倦怠以及医疗服务的不公平。要使患者的需求与医疗技术的进步保持一致,就必须在患者护理环节进行财务整合。复杂性理论为政府、中介机构和患者的角色提供了宝贵的见解。政府作为规则的制定者和系统的裁判,必须注重公平。积极参与共同决策的患者和医疗服务提供者自然会满足众多社区的不同需求。中介机构通过将资源与医疗点联系起来,解决包容性问题。在一个充满活力、服务于不同社区的新兴医疗保健系统中,以患者和社区为基础的融资、代金券和固定缴费是解决文化多样性、包容性和公平问题的必要第一步。
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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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