دانلود مقاله ISI انگلیسی شماره 45826
عنوان فارسی مقاله

اقتصاد سیاسی انتقال برنامه مدیریت مورد بهداشت عمومی به درون خانه های پزشکی

کد مقاله سال انتشار مقاله انگلیسی ترجمه فارسی تعداد کلمات
45826 2015 9 صفحه PDF سفارش دهید 8840 کلمه
خرید مقاله
پس از پرداخت، فوراً می توانید مقاله را دانلود فرمایید.
عنوان انگلیسی
The political economy of a public health case management program's transition into medical homes
منبع

Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)

Journal : Social Science & Medicine, Volume 145, November 2015, Pages 98–106

کلمات کلیدی
پیاده سازی - همکاری بخش خصوصی و دولتی - اقتصاد سیاسی - مدیریت پرونده - خانه های پزشکی - مادر و کودک - بخش بهداشت محلی - خدمات درمانی - ایالات متحده
پیش نمایش مقاله
پیش نمایش مقاله اقتصاد سیاسی انتقال برنامه مدیریت مورد بهداشت عمومی به درون خانه های پزشکی

چکیده انگلیسی

Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent.

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