哮喘联盟

   摘要
   在美国，哮喘影响了710万儿童，不成比例地困扰着非裔和拉定裔儿童。哮喘控制的障碍包括 患者教育不足和零散的护理。护理协调代表着一个提高护理质量和解决哮喘差异的有力方法。默克地区儿童哮喘网络护理协调项目实施不同的护理协调模式以适应特定的学区、诊所或卫生保健系统以及社区和组织机构。对各种各样的定性数据源进行分析，以确定其在每个地区的护理协调表现形式中发挥的作用。在每种环境里实施护理协调存在内在优势和挑战，每个地区使用独特的战略来完成自己的项目。为项目参与者提供了优先权和临床服务的实体，使项目的参与单位与牵头单位之间的关系在项目的结构中发挥了关键作用。这些参与单位提供给牵头单位的支持水平和基础设施水平影响了：参与者如何鉴定以及哮喘护理协调员如何纳入临床护理队伍。

（杨冬 审校）
Health Promot Pract. 2015 Jul 31. pii: 1524839915598499. [Epub ahead of print]


 

The Influence of Setting on Care Coordination for Childhood Asthma.
 

Kelly RP1, Stoll SC2, Bryant-Stephens T3, Janevic MR2, Lara M4, Ohadike YU5, Persky V6, Ramos-Valencia G7,Uyeda K8, Malveaux FJ5.
 

Abstract
Asthma affects 7.1 million children in the United States, disproportionately burdening African American and Latino children. Barriers to asthma control include insufficient patient education and fragmented care. Care coordination represents a compelling approach to improve quality of care and address disparities in asthma. The sites of The Merck Childhood Asthma Network Care Coordination Programs implemented different models of care coordination to suit specific settings-school district, clinic or health care system, and community-and organizational structures. A variety of qualitative data sources were analyzed to determine the role setting played in the manifestation of care coordination at each site. There were inherent strengths and challenges of implementing care coordination in each of the settings, and each site used unique strategies to deliver their programs. The relationship between the lead implementing unit and entities that provided (1) access to the priority population and (2) clinical services to program participants played a critical role in the structure of the programs. The level of support and infrastructure provided by these entities to the lead implementing unit influenced how participants were identified and how asthma care coordinators were integrated into the clinical care team.
 

Health Promot Pract. 2015 Jul 31. pii: 1524839915598499. [Epub ahead of print]