Geographic Differences in Availability and Access to Care Services for Asthma and COPD: Case Study of Vancouver Coastal Health, British Columbia.

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM Canadian respiratory journal Pub Date : 2024-10-28 eCollection Date: 2024-01-01 DOI:10.1155/2024/8019557
Amelia Choy, Erin M Shellington, Aneisha Collins-Fairclough, Nardia Strydom, Chris Carlsten
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Abstract

Background: With a diverse geographic and sociocultural landscape, Vancouver Coastal Health (VCH) Authority (British Columbia, Canada) encompasses both urban and rural regions, providing a case study to examine the delivery of care services for asthma and chronic obstructive pulmonary disease (COPD). To better understand the landscape of care services within VCH, we aimed to (1) identify asthma and COPD care services availability in urban and rural communities and (2) identify where asthma and COPD quality improvement (QI) initiatives were implemented and their implementation-related characteristics. Methods: An environmental scan was conducted to identify asthma and COPD care services provided in VCH communities. A literature review was conducted to determine where VCH asthma and COPD QI initiatives were implemented and identify their implementation-related characteristics. This case study was analysed descriptively and summarised in tables and figures. Results: The environmental scan analysis revealed that specialty outpatient care, pulmonary rehabilitation, respiratory education and clinical smoking cessation services were limited in urban and unavailable in rural VCH communities. Spirometry services were limited in urban and rural VCH communities. Cross-referencing recommendations from asthma and COPD clinical practice guidelines against prevalence data, we estimated that rural VCH communities could provide 0%-23% of required spirometry while urban could provide 40%-75%. Further, of the 16 asthma and COPD QI initiatives identified within 21 papers, none were conducted at rural VCH healthcare sites. Conclusion: Our findings suggest rural VCH communities have lower access to asthma and COPD care services and the limited urban care services were insufficient to make up for this difference. Past asthma and COPD QI initiatives have not apparently translated to care service improvements in rural regions. Future QI initiatives should focus on overcoming barriers to conducting and participating in QI to improve urban and rural regions' access to asthma and COPD care services.

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哮喘和慢性阻塞性肺病护理服务可用性和可及性的地域差异:不列颠哥伦比亚省温哥华海岸卫生局案例研究。
背景:加拿大不列颠哥伦比亚省温哥华沿岸卫生局(VCH)拥有多样化的地理和社会文化景观,包括城市和农村地区,为研究哮喘和慢性阻塞性肺病(COPD)的医疗服务提供了一个案例。为了更好地了解 VCH 内的医疗服务情况,我们的目标是:(1)确定城市和农村社区的哮喘和慢性阻塞性肺病医疗服务可用性;(2)确定哮喘和慢性阻塞性肺病质量改进(QI)计划的实施地点及其实施相关特征。方法:进行环境扫描以确定在 VCH 社区提供的哮喘和慢性阻塞性肺病护理服务。通过文献回顾来确定在哪些地方实施了维多利亚州立医院哮喘和慢性阻塞性肺病质量改进(QI)计划,并确定其与实施相关的特征。对该案例研究进行了描述性分析,并用表格和数字进行了总结。结果环境扫描分析表明,专科门诊护理、肺康复、呼吸教育和临床戒烟服务在城市地区非常有限,而在农村地区的非营利性医疗机构社区则无法提供。肺活量测定服务在城市和农村的非医疗机构社区都很有限。根据哮喘和慢性阻塞性肺病临床实践指南的建议与患病率数据的交叉对比,我们估计农村地区的自愿医疗机构社区可以提供 0%-23% 所需的肺活量测量服务,而城市地区则可以提供 40%-75% 的肺活量测量服务。此外,在 21 篇论文中确定的 16 项哮喘和慢性阻塞性肺病 QI 计划中,没有一项是在农村妇幼保健院开展的。结论:我们的研究结果表明,农村妇幼保健院社区获得哮喘和慢性阻塞性肺病护理服务的机会较少,而有限的城市护理服务不足以弥补这一差异。过去的哮喘和慢性阻塞性肺病 QI 计划显然没有改善农村地区的护理服务。未来的 QI 计划应侧重于克服开展和参与 QI 的障碍,以改善城市和农村地区获得哮喘和慢性阻塞性肺病护理服务的机会。
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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
期刊最新文献
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