کاربردهای خانه بهداشت و مراقبت های اولیه کودکان میان کودکان با نیازهای مراقبت سلامت خاص
قیمت فایل فقط 9,900 تومان
روش های تحقیق
جامعه آماری و نمونه
مقیاس ها و تحلیل
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بخشی از ترجمه فارسی مقاله:
تقریبا 10.2 میلیون کودک در سنین 0 تا 17 ساله در ایالات متحده (14%) نیازهای بهداشت و درمان خاص دارند. کودکانِ با نیازهای بهداشت و درمان خاص (CSHCN) یک گروه متنوع با شرایط سلامتی گوناگون فیزیکی، روانی و رفتاری مشخص شده اند (Strickland et al., 2011)، و معمولا آنها نسبت به کودکان در سنین مشابه، به خدمات بهداشتی بیشتری نیاز دارند (Blumberg et al., 2007;Newacheck, 2007; U.S. Department of Health andHuman Services, 2007). بطور کلی، کودکانِ با نیازهای بهداشت و درمان خاص (CSHCN) بیش از 42% هزینه های پزشکی برای کودکان را به خود اختصاص می دهند (Newacheck & Kim, 2005). اخیرا بوسیله یک تحقیق برآورد شده است که هزینه های بالای مراقبت شاملِ هزینه های بهداشتی کودکانِ با نیازهای بهداشت و درمان خاص (CSHCN) به طور متوسط 3 برابر بیشتر و هزینه های بیمارستانی 4 برابر بیشتر از کودکان سالم است (Cohen et al., 2010).
بخشی از مقاله انگلیسی:
Approximately 10.2 million children ages 0 to 17 years in the United States (14%) have special health care needs. Children with special health care needs (CSHCN) are a diverse group characterized by a variety of physical, mental, and behavioral health conditions (Strickland et al., 2011), and they usually require more health-related services than generally are needed by children of similar ages (Blumberg et al., 2007; Newacheck, 2007; U.S. Department of Health and Human Services, 2007). Overall, CSHCN account for more than 42% of all medical expenditures for children (Newacheck & Kim, 2005). This high cost of care was recently supplemented by a finding that CSHCN health expenditures were on average three times higher and hospital expenses were four times higher than those of healthier children (Cohen et al., 2010). Some studies found that CSHCN made a significantly higher number of physician office visits than did children without special health care needs (Houtrow, Kim, Chen, & Newacheck, 2007; Martin, Crawford, & Probst, 2007). Weller, Minkovitz, and Anderson (2003) noted higher rates of hospitalizations and emergency department (ED) visits among CSHCN with severe functional limitations but found no differences in the number of pediatric primary care (PPC) office visits. According to the 2008 National Survey of Childrens Health, children with special needs had more wellchild visits than did other children (Cooley, McAllister, Sherrieb, & Kuhlthau, 2009). Nageswaran, Roth, Kluttz-Hile, & Farel (2007) reported higher rates of health care needs among CSHCN with greater functional limitations but found no increase in preventive or health assessment office visits. Similarly, a 2004 study found no difference between children with and without special health care needs in terms of preventive care (Bethell, Read, & Brockwood, 2004). Some evidence indicates that CSHCN receive less preventive and wellchild care than their healthy peers because their health care needs may dominate the time and conversation during PPC office visits (Ayyangar, 2002). In recent years, an increasing emphasis has been placed on improving health care delivery for CSHCN in the context of the family and community (American Academy of Pediatrics, 2009; Coker, Rodrigues, & Flores, 2010; National Association of Pediatric Nurse Practitioners, 2009). The American Academy of Pediatrics defined medical home not only as the central location for receiving medical services but also a source of preventive care and a resource for community information and support (American Academy of Pediatrics, 2002). The National Association of Pediatric Nurse Practitioners (2009) supported the approach and proposed to expand the medical home concept to all children and their families in the United States. The Patient Protection and Affordable Care Act (2010) emphasized the need for strong primary care based on the medical home model. The Law also stipulates medical home provisions for persons with chronic medical conditions (Sec. 2703). The presence of a medical home is associated with a number of positive patient outcomes. Research indicates that availability of the medical home has a considerable potential to reduce emergency and urgent care use for all children (American Academy of Pediatrics, 2002; Antonelli, Stille & Antonelli, 2008; Cooley et al., 2009). In fact, a 2008 study found that having at least the recommended number of early periodic screening, diagnostic, and treatment visits might shift some health provision from the ED to the PPC office (Rosenbaum, Wilensky, & Allen, 2008). Strickland, McPherson, and Weissman (2004) found that children without a medical home were more than twice as likely to have unmet health care needs than were those with a medical home. Unmet child health care needs have been linked to a number of socioeconomic factors such as poverty, minority status, lack of health insurance, and lower parental education (Inkelas, Raghavan, Larson, Kuo, & Ortega, 2007; Mayer, Skinner, & Slifkin, 2004; Singh, Strickland, Ghandour, & van Dyck, 2009). The purpose of this study was to examine PPC utilization for CSHCN with a medical home and CSHCN without a medical home. When medical homes provide comprehensive health care services and community information to CSHCN and their families, it is reasonable to assume that more visits to the PPC provider would be needed to address CSHCN acute and chronic conditions in addition to well-child examinations. Thus we hypothesized that having a medical home would be associated with a higher number of PPC office visits. We also posited that some CSHCN sociodemographic characteristics would be associated with a higher number of PPC office visits.
قیمت فایل فقط 9,900 تومان