PDF(Pubmed)
Abstract：
UNASSIGNED: To analyse the mechanisms at play in the adjudications made by professionals and socially vulnerable patients with type 2 diabetes about their eligibility for care.
UNASSIGNED: The study included 14 patients and 10 health professionals in seven general practice surgeries in deprived areas in Greater Copenhagen. The study data consist of 17 semi-structured interviews with patients and 22 with health professionals immediately after observation of 23 consultations. Our analytical approach was inspired by Systematic Text Condensation and the concept of \'candidacy\' for access to health care.
UNASSIGNED: Adjudications of patients not being candidates for services were common, but we also found that both patients and health professionals worked to align the services to the needs of the patients. This could include using services differently than was intended by the providers or by changing routines to make it easier for patients to use the services. We discuss these processes as \'tinkering\'. This usually implies that the best individual solution for the patient is aimed for, and in this study, the best solution sometimes meant not focusing on diabetes.
UNASSIGNED: The study adds to existing knowledge about access to services for socially vulnerable patients by demonstrating that both patients and professionals in general practice engage in tinkering processes to make services work.
Unequal use and benefits of health services play a significant role in relation to social inequality in healthFlexibility in services and alternatives to school-like rehabilitation are needed to reduce inequality in access to health carePatients were sometimes judged as unsuitable for available routine services, but professionals ‘tinkered’ with services to make them fitAdaptation of services by professionals in general practice implies a longer time frame for obtaining goals.
UNASSIGNED: The study included 14 patients and 10 health professionals in seven general practice surgeries in deprived areas in Greater Copenhagen. The study data consist of 17 semi-structured interviews with patients and 22 with health professionals immediately after observation of 23 consultations. Our analytical approach was inspired by Systematic Text Condensation and the concept of \'candidacy\' for access to health care.
UNASSIGNED: Adjudications of patients not being candidates for services were common, but we also found that both patients and health professionals worked to align the services to the needs of the patients. This could include using services differently than was intended by the providers or by changing routines to make it easier for patients to use the services. We discuss these processes as \'tinkering\'. This usually implies that the best individual solution for the patient is aimed for, and in this study, the best solution sometimes meant not focusing on diabetes.
UNASSIGNED: The study adds to existing knowledge about access to services for socially vulnerable patients by demonstrating that both patients and professionals in general practice engage in tinkering processes to make services work.
Unequal use and benefits of health services play a significant role in relation to social inequality in healthFlexibility in services and alternatives to school-like rehabilitation are needed to reduce inequality in access to health carePatients were sometimes judged as unsuitable for available routine services, but professionals ‘tinkered’ with services to make them fitAdaptation of services by professionals in general practice implies a longer time frame for obtaining goals.
摘要：
■分析专业人员和社会脆弱的2型糖尿病患者关于他们是否有资格接受护理的裁决中的机制。
■该研究包括14名患者和10名卫生专业人员，他们在大哥本哈根贫困地区进行了7次全科手术。研究数据包括对患者进行的17次半结构化访谈和对23次咨询的观察后立即对健康专业人员进行的22次访谈。我们的分析方法受到系统文本冷凝和获得医疗保健的“候选人资格”概念的启发。
■对患者不是服务候选人的裁决很常见，但我们还发现，患者和卫生专业人员都努力使服务符合患者的需求。这可能包括使用与提供商预期不同的服务，或者通过更改例程以使患者更容易使用服务。我们将这些过程称为“修补”。这通常意味着患者的最佳个人解决方案旨在，在这项研究中，最好的解决方案有时意味着不关注糖尿病。
该研究通过证明患者和全科医生都参与修补程序以使服务工作，从而增加了有关社会弱势患者获得服务的现有知识。
卫生服务的不平等使用和好处在健康方面的社会不平等方面发挥着重要作用。需要提供服务的灵活性和学校式康复的替代方案，以减少获得医疗保健的不平等。有时，患者被认为不适合提供常规服务，但是专业人员“修补”服务以使其适合一般实践中的专业人员对服务的适应意味着获得目标的时间框架更长。
■该研究包括14名患者和10名卫生专业人员，他们在大哥本哈根贫困地区进行了7次全科手术。研究数据包括对患者进行的17次半结构化访谈和对23次咨询的观察后立即对健康专业人员进行的22次访谈。我们的分析方法受到系统文本冷凝和获得医疗保健的“候选人资格”概念的启发。
■对患者不是服务候选人的裁决很常见，但我们还发现，患者和卫生专业人员都努力使服务符合患者的需求。这可能包括使用与提供商预期不同的服务，或者通过更改例程以使患者更容易使用服务。我们将这些过程称为“修补”。这通常意味着患者的最佳个人解决方案旨在，在这项研究中，最好的解决方案有时意味着不关注糖尿病。
该研究通过证明患者和全科医生都参与修补程序以使服务工作，从而增加了有关社会弱势患者获得服务的现有知识。
卫生服务的不平等使用和好处在健康方面的社会不平等方面发挥着重要作用。需要提供服务的灵活性和学校式康复的替代方案，以减少获得医疗保健的不平等。有时，患者被认为不适合提供常规服务，但是专业人员“修补”服务以使其适合一般实践中的专业人员对服务的适应意味着获得目标的时间框架更长。
