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Mixed Methods Evaluation of State Targeted Response to the Opioid Crisis in Ohio 俄亥俄州阿片类药物危机国家目标反应的混合方法评估
Pub Date : 2023-01-23 DOI: 10.18061/ojph.v5i2.8979
R. T. Sherba, Julia Dionne, Jessica Linley
Background: In 2017, the Substance Abuse and Mental Health Services Administration awarded State Targeted Response (STR) grants through the 21st Century Cures Act to help states address the opioid crisis. While there are publications that discuss how each state allocated their STR grant awards, there is a paucity of evaluations illustrating the impact of STR grant activities on clients of opioid use disorder (OUD) treatment, family members of persons living with OUD, community professionals whose work involves addressing OUD, as well as impacts on local communities. This longitudinal qualitative study assessed the impact of STR grant-funded projects on communities in Ohio particularly hard hit by the opioid epidemic.Methods: Data were collected through a mixed research methodology from November 2017 through April 2019. Epidemiologists conducted focus groups and administered surveys in 4 geographically different areas of the state. Study objectives included assessments of community messaging related to opioids, level of perceived stigma for OUD, knowledge of available services and processes for accessing them, and perception of community treatment service needs.Results: A total of 940 respondents participated in 3 cycles (6 months each) of focus groups. Key findings included increased naloxone knowledge and experience, increased proportion of persons living with OUD receiving medication-assisted treatment (MAT), and a 2.5 time increase in the number of reported positive observations of community change. While the level of perceived stigma for OUD remained consistent (moderate) throughout the study, respondents throughout cycles observed an increasing number of community approaches, such as public awareness campaigns and recovery rallies, to impart knowledge, change attitudes, and reduce stigma.Conclusion: Evaluations of STR funded activities and programs could help illustrate the value that additional funding might have over time in reducing stigma related to OUD and increasing knowledge of available treatment services in communities.
背景:2017年,药物滥用和心理健康服务管理局通过《21世纪治疗法》授予国家定向反应(STR)拨款,以帮助各州应对阿片类药物危机。虽然有出版物讨论了各州如何分配STR赠款,但很少有评估表明STR赠款活动对阿片类药物使用障碍(OUD)治疗客户、OUD患者的家庭成员、工作涉及解决OUD的社区专业人员以及对当地社区的影响。这项纵向定性研究评估了STR赠款资助项目对俄亥俄州受阿片类药物流行影响特别严重的社区的影响。方法:2017年11月至2019年4月,通过混合研究方法收集数据。流行病学家在该州4个地理位置不同的地区进行了焦点小组和调查。研究目标包括评估与阿片类药物相关的社区信息、对OUD的污名程度、对现有服务和获得这些服务的过程的了解,以及对社区治疗服务需求的看法。结果:共有940名受访者参加了3个周期(每个周期6个月)的焦点小组。关键发现包括纳洛酮知识和经验的增加,接受药物辅助治疗(MAT)的OUD患者比例的增加,以及报告的社区变化阳性观察人数增加了2.5倍。尽管在整个研究过程中,对OUD的污名程度保持一致(中等),但在整个周期中,受访者观察到越来越多的社区方法,如公众意识运动和康复集会,以传授知识、改变态度和减少污名。结论:对STR资助的活动和计划的评估有助于说明随着时间的推移,额外的资金在减少与OUD相关的污名化和增加对社区可用治疗服务的了解方面可能具有的价值。
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引用次数: 0
From Procurement to Consumption: A Model to Understand Nutrition Policy Implementation in Permanent Supportive Housing 从采购到消费:一个理解永久性保障性住房营养政策实施的模型
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.8829
Rebekah Russell, Briana Mcintosh, N. Palmer, Morgan Taggart, Erika S. Trapl
Background: Food insecurity has become an increasingly complex public health issue across the United States, particularly among various people battling with current or previous homelessness. This project sought to understand the food system in permanent supportive housing sites (PSH) that serve formerly homeless individuals and to explore the use of nutrition standards, specifically the Food Service Guidelines for Federal Facilities (FSGFFs), in this context.Methods: Participants were members of the administrative staff involved in the food procurement process, food preparation, administrative tasks, and daily operations in a small-intensive program managed by a local nonprofit agency that serves 12 adults over the age of 18 who experience chronic homelessness and persistent mental illness, or substance use disorders, and a second PSH site that helps 41 low-income adults with health conditions experiencing homelessness. The PSH Inquiry Tool (PSH-IT) was developed to better understand the business operations at each site, and the PSH Audit (PSH-A) was created to assess the applicability of FSGFF at each site.Results: Findings suggest that funding mechanisms, staff training, staff capacity, and access to nutrition education were critical barriers to the successful development and implementation of nutrition standards in PSH sites. Furthermore, findings suggest that adaptations to FSGFFs are required before implementation at PSH sites.Conclusion: This report advocates for increased involvement of community stakeholders to support nutrition policy development and implementation, a nutrition policy that impacts all levels of the food system from procurement to consumption, and local, state, or federal policy changes to support improved nutrition in PSH.
背景:在美国,食品不安全已成为一个日益复杂的公共卫生问题,特别是在与目前或以前的无家可归作斗争的各种人群中。本项目旨在了解永久性支持性住房站点(PSH)的食品系统,这些站点为以前无家可归的人提供服务,并在此背景下探索营养标准的使用,特别是联邦设施食品服务指南(FSGFFs)。方法:参与者是参与食品采购过程、食品准备、行政任务和日常操作的行政人员,在一个由当地非营利机构管理的小型密集项目中,该项目为12名18岁以上的成年人提供服务,这些成年人患有慢性无家可归和持续性精神疾病,或物质使用障碍,第二个PSH站点帮助41名患有健康状况的低收入成年人无家可归。PSH查询工具(PSH- it)的开发是为了更好地了解每个站点的业务运作,PSH审计(PSH- a)的创建是为了评估FSGFF在每个站点的适用性。结果:研究结果表明,资金机制、工作人员培训、工作人员能力和获得营养教育是PSH站点成功制定和实施营养标准的关键障碍。此外,研究结果表明,在PSH站点实施前,需要对FSGFFs进行适应。结论:本报告提倡增加社区利益相关者的参与,以支持营养政策的制定和实施,营养政策影响从采购到消费的食品系统的各个层面,以及地方,州或联邦政策的变化,以支持改善PSH的营养。
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引用次数: 0
Virtual Alternatives and Technological Disparities 虚拟替代与技术差距
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.9146
Sheryl L. Chatfield
No abstract available.
没有摘要。
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引用次数: 0
The Importance of Communication in Collaborative Community Development: Lessons Learned from Three Cases 沟通在社区合作发展中的重要性——三个案例的经验教训
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.8721
A. Leuchtag, Luke Bressler, Ashley R. Banks, Daniel Skinner
Collaborative community development projects aimed at promoting economic vitality, with attendant consequences as a key social determinant of health, necessarily pose questions about how to best communicate between developers, project partners, and community members. Many such projects are taking place across the United States, including in Ohio. This commentary draws on examples from 3 communities (2 outside of our state of Ohio, and another in the Linden neighborhood of Columbus, Ohio) to distill 3 key lessons in the area of communication. First, we argue that communication should be proactive, not reactive. Second, we explain why planners should be consistent in the provision of updates related to progress or lack thereof in real time on websites and apps, all while ensuring that information remains current. Third, though communication remains an under-appreciated aspect of partnership-based community development work, including explicitly health-oriented work, we argue that communicating progress to community members is not only logistically important, but part of a broader effort to build trust within communities in order to create long-lasting and sustainable change. This trust, after all, is a necessary foundation for community-focused workconcerned with addressing the social determinants of health.
旨在促进经济活力的合作社区发展项目,以及作为健康关键社会决定因素的随之而来的后果,必然会提出如何在开发商、项目合作伙伴和社区成员之间进行最佳沟通的问题。许多这样的项目正在美国各地进行,包括俄亥俄州。这篇评论引用了3个社区的例子(俄亥俄州以外的2个社区,俄亥俄州哥伦布市林登社区的另一个社区),提炼出沟通领域的3个关键经验教训。首先,我们认为沟通应该是主动的,而不是被动的。其次,我们解释了为什么规划者应该在网站和应用程序上实时提供与进展或缺乏进展相关的更新,同时确保信息保持最新。第三,尽管沟通仍然是基于伙伴关系的社区发展工作的一个不受重视的方面,包括明确以健康为导向的工作,但我们认为,向社区成员传达进展不仅在逻辑上很重要,而且是在社区内建立信任以创造持久和可持续变革的更广泛努力的一部分。毕竟,这种信任是以社区为中心的工作的必要基础,这些工作涉及解决健康的社会决定因素。
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引用次数: 0
Perceptions of How Integrated Care Impacts Treatment in Rural Settings 综合护理如何影响农村环境中的治疗
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.8394
D. Graham, Samantha Nandyal, Salonas Ayad
Background: In light of the changing face of health care, it is important that practitioners and researchers begin to think strategically regarding comprehensive and accessible care. The purpose of this research study is to provide a deeper understanding of change among health care providers who work on multidisciplinary teams and the impact on patient outcomes.Methods: This research was designed as an exploratory phenomenological research study. The experience of interest was how providers described changes in care when working in an integrated care context. Eight semistructured in-depth interviews were conducted with physicians, nurse practitioners, social workers, and psychologists from locations in Southern Ohio, Central Maine, and Eastern Tennessee. Data were analyzed using qualitative coding to find patterns with and across participants associated with their perceptions of health integration.Results: Final developed themes described provider perceptions of working in an integrated care environment, and included access to care, interprofessional education, communication between providers.Conclusion: Through interviews and a review of the literature, we have found that as integrated care is employed throughout the country, patients have better health outcomes and providers experience efficient and effective work environments. Providers have adapted to the changing environment of integrative medicine; through this study we see that these changes have been for the benefit of the patients. Patients who disproportionately suffer from a lack of health care resources, such as those in rural areas, may benefit greatly from an integrated care model.
背景:鉴于卫生保健不断变化的面貌,重要的是从业人员和研究人员开始对全面和可及的护理进行战略思考。本研究的目的是为了更深入地了解在多学科团队中工作的卫生保健提供者之间的变化及其对患者预后的影响。方法:本研究为探索性现象学研究。感兴趣的经验是提供者如何描述在综合护理环境中工作时护理的变化。研究人员对来自俄亥俄州南部、缅因州中部和田纳西州东部的医生、护士、社会工作者和心理学家进行了八次半结构化的深度访谈。使用定性编码对数据进行分析,以发现参与者之间以及参与者之间与他们对健康整合的看法相关的模式。结果:最终发展的主题描述了提供者对在综合护理环境中工作的看法,包括获得护理,跨专业教育,提供者之间的沟通。结论:通过访谈和文献回顾,我们发现,在全国范围内采用综合护理,患者有更好的健康结果,提供者体验到高效和有效的工作环境。提供者已经适应了中西医结合不断变化的环境;通过这项研究,我们看到这些变化对患者有益。严重缺乏保健资源的病人,例如农村地区的病人,可能会从综合护理模式中受益匪浅。
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引用次数: 0
Depressive Symptoms and Perception of COVID-19 Risk in Ohio Adults 俄亥俄州成年人的抑郁症状和COVID-19风险感知
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.8805
Katarina M. Bischof, P. Chakraborty, W. Miller, A. Turner
Background: We assessed the relationship between depressive symptoms and perceived COVID-19 risk in the next month.Methods: This analysis used survey data collected during a July 2020 cross-sectional study using a household-based probability sampling design. A total of 615 noninstitutionalized, English- and/or Spanish-speaking adults in Ohio were included. Depressive symptoms screening occurred using the Patient Health Questionnaire-2 (PHQ-2). We applied survey weights so that presented analyses represent the adult population in Ohio. We performed log-risk regression modeling (generalized linear model with binomial distribution and log link) to estimate unadjusted and covariate-adjusted prevalence ratios examining the association between screening positive for depressive symptoms and perceived risk of COVID-19 in the next month.Results: The study population was majority female (59.1%) and White (90.3%). The mean age was 55.9 years (standard deviation (SD)=17.3). About 1 in 20 (4.6%) screened positive for depressive symptoms. A positive depressive symptoms screen was not significantly associated with perceived risk of COVID-19 in the next month (prevalence ratio [PR]=0.75; 95% confidence interval [CI]=0.25–2.24). After confounder adjustment, the adjusted prevalence ratio (aPR) was nearly unchanged (aPR=0.78; 95% CI=0.24–2.55).Conclusion: As depression is often associated with anxiety and pessimism toward the future, the lack of association between depressive symptoms screening and perception of COVID-19 risk in the next month is surprising. Social withdrawal, which is also associated with depression, may have concealed any increased perceived COVID-19 risk, as depressed individuals who remained socially isolated may have had lower perceived COVID-19 risk.
背景:我们评估抑郁症状与下个月感知的COVID-19风险之间的关系。方法:本分析使用了2020年7月采用基于家庭的概率抽样设计的横断面研究收集的调查数据。在俄亥俄州,共有615名非收容的、说英语和/或西班牙语的成年人被纳入研究。使用患者健康问卷-2 (PHQ-2)进行抑郁症状筛查。我们应用了调查权重,因此所提出的分析代表了俄亥俄州的成年人口。我们采用对数风险回归模型(具有二项分布和对数链接的广义线性模型)来估计未经调整和协变量调整的患病率,以检验抑郁症状筛查阳性与下个月COVID-19感知风险之间的关系。结果:研究人群以女性(59.1%)和白人(90.3%)为主。平均年龄55.9岁(标准差(SD)=17.3)。20人中约有1人(4.6%)的抑郁症状筛查呈阳性。抑郁症状筛查阳性与下个月COVID-19的感知风险无显著相关(患病率比[PR]=0.75;95%置信区间[CI]= 0.25-2.24)。经混杂校正后,调整后的患病率(aPR)几乎没有变化(aPR=0.78;95% CI = 0.24 - -2.55)。结论:抑郁症通常与焦虑和对未来的悲观情绪有关,因此抑郁症状筛查与下个月对COVID-19风险的感知之间缺乏关联令人惊讶。社交退缩也与抑郁症有关,它可能掩盖了任何增加的COVID-19感知风险,因为保持社交孤立的抑郁症患者可能具有较低的COVID-19感知风险。
{"title":"Depressive Symptoms and Perception of COVID-19 Risk in Ohio Adults","authors":"Katarina M. Bischof, P. Chakraborty, W. Miller, A. Turner","doi":"10.18061/ojph.v5i1.8805","DOIUrl":"https://doi.org/10.18061/ojph.v5i1.8805","url":null,"abstract":"Background: We assessed the relationship between depressive symptoms and perceived COVID-19 risk in the next month.\u0000Methods: This analysis used survey data collected during a July 2020 cross-sectional study using a household-based probability sampling design. A total of 615 noninstitutionalized, English- and/or Spanish-speaking adults in Ohio were included. Depressive symptoms screening occurred using the Patient Health Questionnaire-2 (PHQ-2). We applied survey weights so that presented analyses represent the adult population in Ohio. We performed log-risk regression modeling (generalized linear model with binomial distribution and log link) to estimate unadjusted and covariate-adjusted prevalence ratios examining the association between screening positive for depressive symptoms and perceived risk of COVID-19 in the next month.\u0000Results: The study population was majority female (59.1%) and White (90.3%). The mean age was 55.9 years (standard deviation (SD)=17.3). About 1 in 20 (4.6%) screened positive for depressive symptoms. A positive depressive symptoms screen was not significantly associated with perceived risk of COVID-19 in the next month (prevalence ratio [PR]=0.75; 95% confidence interval [CI]=0.25–2.24). After confounder adjustment, the adjusted prevalence ratio (aPR) was nearly unchanged (aPR=0.78; 95% CI=0.24–2.55).\u0000Conclusion: As depression is often associated with anxiety and pessimism toward the future, the lack of association between depressive symptoms screening and perception of COVID-19 risk in the next month is surprising. Social withdrawal, which is also associated with depression, may have concealed any increased perceived COVID-19 risk, as depressed individuals who remained socially isolated may have had lower perceived COVID-19 risk.","PeriodicalId":74337,"journal":{"name":"Ohio journal of public health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44511348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Adverse Childhood Experiences, Race, and Health Outcomes: Examining a Synergistic Relationship 不良童年经历、种族和健康结果:检验协同关系
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.8982
Helen Gu, N. Vallabh, W. Motley
Background: Adverse childhood experiences (ACEs) are potentially traumatic incidents occurring before age 18 years. Adverse childhood experiences include physical or mental abuse, financial stress, home or community violence, substance misuse, familial turmoil, and other factors. Adverse childhood experiences are associated with negative health outcomes in adulthood. Methods: Numerous research studies and systematic reviews were reviewed to assess the breadth and depth of racial and ethnic inclusivity in ACE research.Results: A wide range of ACEs have been investigated, and ample state-level data is publicly available. Early, fundamental ACE studies typically recruited White, educated, and insured participants; racial and ethnic diversity were often neglected.Conclusion: Adverse childhood experiences and race have been found exerting synergistic effects on adult health outcomes. Further evaluation of race is warranted to improve health outcomes. Scrutiny of racial and ethnic equity in health research is paramount for achieving health equity.
背景:不良童年经历(ace)是指发生在18岁之前的潜在创伤性事件。不良的童年经历包括身体或精神虐待、经济压力、家庭或社区暴力、药物滥用、家庭动荡和其他因素。不良的童年经历与成年后的负面健康结果有关。方法:回顾了大量的研究和系统综述,以评估ACE研究中种族和民族包容性的广度和深度。结果:广泛的ace已被调查,并有充足的州级数据公开可用。早期,基础ACE研究通常招募受过教育和有保险的白人参与者;种族和民族多样性经常被忽视。结论:童年不良经历和种族对成人健康结果有协同效应。有必要对种族进行进一步评估,以改善健康结果。对卫生研究中的种族和族裔平等进行审查对于实现卫生平等至关重要。
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引用次数: 0
Hearing Loss: Applying the Social-Ecological Model for Change 听力损失:应用社会生态模型进行改变
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.8386
A. Hinson-Enslin, H. McClintock
Introduction: The proportion of Ohioans experiencing deafness or serious difficulty hearing is higher than national estimates and is increasing over time.Purpose: The purpose of this study is to describe the burden, risk factors, comorbidities, and financial implications of hearing loss in Ohio as well as discuss approaches to reduce the burden of hearing loss in Ohio applying the Social-Ecological ModelMethods: A narrative review was completed to summarize peer-reviewed literature on hearing loss in Ohio. The Social-Ecological Model was applied to identify approaches to reduce the burden of hearing loss in Ohio.Results: The burden of hearing loss on health and economic well-being is substantial in Ohio. While initiatives have sought to reduce costs and increase access, barriers continue to persist impeding people’s ability to obtain needed services in Ohio. Approaches were identified on all levels of the Social-Ecological Model to address the burden of hearing loss in Ohio such as creating interventions for prevention, improving access to hearing tests and hearing aids, and changing policies that expand insurance coverage for hearing aids.Conclusion: There is a critical need for public health-initiated programs and policies that reduce barriers and increase access to hearing related services that can be implemented on all levels of the Social-Ecological Model.
引言:俄亥俄州耳聋或听力严重困难的比例高于全国估计,而且随着时间的推移,这一比例还在增加。目的:本研究的目的是描述俄亥俄州听力损失的负担、风险因素、合并症和财务影响,并讨论应用社会生态模型减轻俄亥俄州听力损伤负担的方法。方法:完成叙述性综述,总结俄亥俄州听力损失的同行评审文献。应用社会生态模型来确定俄亥俄州减轻听力损失负担的方法。结果:俄亥俄州听力损失对健康和经济福祉的负担很大。尽管各项举措试图降低成本并增加获得服务的机会,但障碍仍然存在,阻碍了俄亥俄州人民获得所需服务的能力。在社会生态模型的各个层面上确定了解决俄亥俄州听力损失负担的方法,如制定预防干预措施,改善听力测试和助听器的使用,以及改变扩大助听器保险范围的政策。结论:迫切需要公共卫生启动的计划和政策,以减少障碍,增加获得听力相关服务的机会,这些计划和政策可以在社会生态模式的各个层面上实施。
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引用次数: 0
Referrals to Mental Health Services in Ohio: An Exploration of Time to First Referral After Completion of Mental Health First Aid Gatekeeper Training 俄亥俄州的心理健康服务转诊:心理健康急救员培训完成后首次转诊时间的探索
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.8478
J. Song, Kimberly R. Laurene, D. Kenne
Background: The college population is particularly vulnerable to mental health challenges. In 2020 only 46.2% of people with a mental illness received mental health services. Mental Health First Aid (MHFA) is a training course designed to teach people how to connect individuals in need of professional services to the appropriate resources.Methods: Mental Health First Aid (MHFA) trainings were offered to students, faculty, and staff at Kent State University. Data from 343 individuals, who completed the MHFA gatekeeper training, were analyzed to explore the impact of time and participant characteristics on the likelihood of first referral to mental health services after completion of the MHFA. Participants completed a pretraining and posttraining paper questionnaire on the day of MHFA training and received a monthly online follow-up survey to assess self-reported referrals over time.Results: After completing MHFA, the average time until first referral was approximately 3 months. Several participant characteristics were significantly associated with referral to mental health services. African American and Black participants who completed the training were more likely to make a referral as compared to White participants. Extraversion was associated with increased likelihood of making a referral, while emotional stability was associated with a decreased likelihood of making a referral.Conclusion: Participants were 5.7% less likely to first report referring with each passing month following the MHFA training, suggesting that there may be cause for an MHFA or similar gatekeeper “booster” course to highlight the importance of making referrals.
背景:大学人群特别容易受到心理健康挑战的影响。2020年,只有46.2%的精神疾病患者接受了心理健康服务。心理健康急救(MHFA)是一门培训课程,旨在教人们如何将需要专业服务的个人与适当的资源联系起来。方法:肯特州立大学为学生、教职员工提供心理健康急救(MHFA)培训。对343名完成MHFA看门人培训的个人的数据进行了分析,以探讨时间和参与者特征对完成MHFA后首次转诊到心理健康服务的可能性的影响。参与者在MHFA培训当天完成了培训前和培训后的纸质问卷,并接受了每月一次的在线随访调查,以评估一段时间内自我报告的转诊情况。结果:完成MHFA后,第一次转诊的平均时间约为3个月。一些参与者的特征与转诊到心理健康服务显著相关。与白人参与者相比,完成培训的非裔美国人和黑人参与者更有可能转介。外向与转诊的可能性增加有关,而情绪稳定与转诊可能性降低有关。结论:参与者在MHFA培训后的每个月首次报告转介的可能性降低了5.7%,这表明可能有理由开设MHFA或类似的看门人“加强”课程来强调转介的重要性。
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引用次数: 0
Patient Access to Care: In-Network and Out-of-Network Utilization of Services 患者获得护理:网络内和网络外的服务利用
Pub Date : 2022-08-24 DOI: 10.18061/ojph.v5i1.8673
B. Lanese, Nora Alrubaie
Background: Access to health care is impacted by several key factors such as urbanization, insurance coverage, availability of health care facilities, specialists, and equipment. For an in-depth understanding of Portage County area residents' health care utilization location choices, a study was conducted to identify the main factors and assess health care outmigration.Methods: A total of 125 292 patients were identified using 2019 administrative health data from University Hospitals Portage Medical Center in Portage County, Ohio. A descriptive analysis, t test, and chi-square tests were used to examine 3 primary outcomes: (1) patients’ demographics (age, gender, insurance, etc.), (2) time and distance patients are willing to travel for care, and (3) health services demand that is causing outmigration. Results: An analysis of 119 034 patients showed 66% of patients stayed in network and 34% went out of network. In-network participants had an average travel time of 30 minutes [95% CI, 29.5 to 29.8] and an average distance of 19.4 miles [95% CI, 15.9 to 16.1]. Conversely, out-of-network participants averaged 43 minutes [95% CI, 43.1 to 43.5] and 30.8 miles [95% CI, 30.4 to 30.8]. Outmigration was mainly influenced by the need for radiology services (66.3%), specifically mammograms (12.7%), computerized tomography (CT) (39.2%), and lab (18.2%).Conclusion: Outmigration can negatively impact a county's health care infrastructure and growth and contribute to a loss of revenue to the local hospitals. In this case, out-of-network services are more commonly used for radiology and lab work than for chronic conditions. It is recommended that both physicians and patients become knowledgeable about the impact of seeking out-of-network care
背景:获得卫生保健受到几个关键因素的影响,如城市化、保险覆盖率、卫生保健设施、专家和设备的可用性。为深入了解波蒂奇县地区居民的医疗保健利用区位选择,本研究确定了主要影响因素,并对医疗保健外迁进行了评估。方法:使用俄亥俄州Portage县大学医院Portage医疗中心的2019年行政健康数据,共确定125 292例患者。采用描述性分析、t检验和卡方检验来检验3个主要结局:(1)患者的人口统计学(年龄、性别、保险等),(2)患者愿意外出治疗的时间和距离,以及(3)导致外迁的卫生服务需求。结果:对11934例患者的分析显示,66%的患者留在网络中,34%的患者离开网络。网络内参与者的平均出行时间为30分钟[95% CI, 29.5至29.8],平均距离为19.4英里[95% CI, 15.9至16.1]。相反,网络外参与者平均为43分钟[95% CI, 43.1至43.5]和30.8英里[95% CI, 30.4至30.8]。外迁主要受放射学服务需求(66.3%)的影响,特别是乳房x光检查(12.7%)、计算机断层扫描(39.2%)和实验室检查(18.2%)。结论:外迁会对一个县的卫生保健基础设施和发展产生负面影响,并导致当地医院的收入损失。在这种情况下,网络外服务更常用于放射学和实验室工作,而不是慢性病。建议医生和患者都了解寻求网络外护理的影响
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引用次数: 0
期刊
Ohio journal of public health
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