COVID-19 大流行对患者健康相关社会需求导航的影响:责任健康社区模式的反思》。

IF 1.5 4区 医学 Q3 FAMILY STUDIES Family & Community Health Pub Date : 2024-07-01 Epub Date: 2024-05-13 DOI:10.1097/FCH.0000000000000402
Julianne Payne, Kelli DePriest, Megan L Clayton, Olivia K G Berzin, Jeanette M Renaud
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引用次数: 0

摘要

背景和目标:本文利用医疗保险与医疗补助创新中心(Center for Medicare & Medicaid Innovation)负责任健康社区(AHC)模式的数据,评估 COVID-19 大流行对患者导航(PN)的影响,以满足与健康相关的社会需求:我们分析了 28 家实施医疗保险与医疗补助创新中心 AHC 模式的机构的评估数据。我们首先从 2021 年进行的 81 次利益相关者访谈中提炼出主题。然后,我们对 2019 年 1 月至 2021 年 3 月期间符合导航资格的 133,173 名医疗保险和医疗补助受益人接受导航的受益人级别的定量数据进行了分析:在大流行期间,访谈参与者描述了患者病例的复杂性以及社区服务可用性的不确定性。导航人员配备和模式的改变提高了导航的质量和效率,但也带来了一些挑战,如与患者的关系不融洽。大流行增加了导航员的压力和倦怠感,但也加深了导航员及其患者对导航的感激之情。与大流行前相比,大流行期间的受益人更容易接受导航服务(P 结论):大流行期间 PN 的变化既有好的一面,也有坏的一面。未来还需要开展工作,评估大流行期间导航相关变化对患者和导航员的长期影响。
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Effects of the COVID-19 Pandemic on Patient Navigation for Health-Related Social Needs: Reflections From the Accountable Health Communities Model.

Background and objectives: This paper uses data from the Center for Medicare & Medicaid Innovation's Accountable Health Communities (AHC) Model to assess the effects of the COVID-19 pandemic on patient navigation (PN) for health-related social needs.

Methods: We analyzed evaluation data from 28 organizations implementing the Center for Medicare & Medicaid Innovation's AHC Model. We first distilled themes from 81 stakeholder interviews conducted in 2021. We then analyzed quantitative beneficiary-level data on acceptance of navigation among 133,173 unique Medicare and Medicaid beneficiaries who were eligible for navigation between January 2019 and March 2021.

Results: During the pandemic, interview participants described greater complexity of patients' cases and uncertainty regarding community service availability. Changes to navigation staffing and mode led to improvements in navigation quality and efficiency, but also challenges such as reduced rapport with patients. The pandemic increased navigator stress and burnout but also deepened appreciation for navigation among navigators and their patients. Beneficiaries were more likely to accept navigation during the pandemic than before the pandemic ( P < .05).

Conclusions: Changes in PN during the pandemic were perceived as both good and bad. Future work is needed to assess the long-term implications of pandemic-related changes to navigation for patients and navigators.

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来源期刊
CiteScore
2.70
自引率
4.30%
发文量
69
期刊介绍: Family & Community Health is a practical quarterly which presents creative, multidisciplinary perspectives and approaches for effective public and community health programs. Each issue focuses on a single timely topic and addresses issues of concern to a wide variety of population groups with diverse ethnic backgrounds, including children and the elderly, men and women, and rural and urban communities.
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