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Schweiberger K, Patel M, Ragavan MI. Promoting Equity in Pediatric Health Care Through Language Services Reimbursement. Pediatrics 2024; 153:e2023064214. [PMID: 38567419 PMCID: PMC11035156 DOI: 10.1542/peds.2023-064214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 04/04/2024] Open
Affiliation(s)
- Kelsey Schweiberger
- Division of General Academic Pediatrics, University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh, Pennsylvania
| | - Mona Patel
- Department of Pediatrics, Children’s Hospital Los Angeles, California
| | - Maya I. Ragavan
- Division of General Academic Pediatrics, University of Pittsburgh and UPMC Children’s Hospital of Pittsburgh, Pennsylvania
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Flower KB, Gutierrez-Wu JC, McBride JP, Sylvester F, Díaz-González de Ferris ME. Spanish-Speaking Parents' Experiences Accessing Care: Evolving Challenges and Promising Approaches. Acad Pediatr 2024; 24:391-393. [PMID: 38253176 DOI: 10.1016/j.acap.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/22/2023] [Accepted: 01/17/2024] [Indexed: 01/24/2024]
Affiliation(s)
- Kori B Flower
- Division of General Pediatrics and Adolescent Medicine (KB Flower, JC Gutierrez-Wu, JP McBride, and ME Díaz-González de Ferris), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC.
| | - Jennifer C Gutierrez-Wu
- Division of General Pediatrics and Adolescent Medicine (KB Flower, JC Gutierrez-Wu, JP McBride, and ME Díaz-González de Ferris), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research (JC Gutierrez-Wu), University of North Carolina, Chapel Hill, NC
| | - Jennifer Pilotos McBride
- Division of General Pediatrics and Adolescent Medicine (KB Flower, JC Gutierrez-Wu, JP McBride, and ME Díaz-González de Ferris), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Francisco Sylvester
- Division of Pediatric Gastroenterology (F Sylvester), Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Maria E Díaz-González de Ferris
- Division of General Pediatrics and Adolescent Medicine (KB Flower, JC Gutierrez-Wu, JP McBride, and ME Díaz-González de Ferris), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC
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Azar R, Chan R, Sarkisian M, Burns RD, Marcin JP, Gotthardt C, De Guzman KR, Rosenthal JL, Haynes SC. Adapting telehealth to address health equity: Perspectives of primary care providers across the United States. J Telemed Telecare 2024:1357633X241238780. [PMID: 38515372 DOI: 10.1177/1357633x241238780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
BACKGROUND Telehealth has the potential to increase access to care for medically underserved patients. This qualitative study aimed to identify telecare practices used during the COVID-19 pandemic to meet the needs of patients experiencing homelessness, patients with disabilities, and patients with language preference other than English (LOE). METHODS We conducted a secondary qualitative data analysis of 47 clinician interviews at Federally Qualified Health Centers (FQHCs) around the country. Using thematic analysis, transcripts were coded by line-by-line by five qualitative researchers. A multidisciplinary team of telehealth experts, researchers and primary care clinicians reviewed memos and excerpts to generate major themes. RESULTS We identified six main areas demonstrating how community providers developed strategies or practices to improve access to care for vulnerable patients: reaching patients experiencing homelessness, serving deaf and hard of hearing patients, improving access for patients with disabilities, serving patients with LOE, improving access for mental and behavioral health services, and educating patients about telehealth. During the pandemic, FQHCs developed innovative solutions to provide access to care for the unhoused, including using telehealth in shelters, vans, and distributing devices like mobile phones and tablets. Telehealth reduced transportation burdens for patients with disabilities and reduced no-show rates for mental health services by adapting group therapy via telehealth features (like break-out rooms) and increasing provider capacity. CONCLUSION Our study identified strategies adopted by FQHCs to serve underserved populations during the COVID-19 pandemic. Our findings highlight the need for enduring strategies to improve health equity through telehealth..
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Affiliation(s)
- Rachel Azar
- UC Davis School of Medicine, Sacramento, CA, USA
| | - Rachel Chan
- UC Davis School of Medicine, Sacramento, CA, USA
| | | | | | - James P Marcin
- UC Davis School of Medicine, Sacramento, CA, USA
- Department of Pediatrics, UC Davis Health, Sacramento, CA, USA
- Center for Health and Technology, UC Davis Health, Sacramento, CA, USA
| | | | - Keshia R De Guzman
- School of Pharmacy, The University of Queensland, Brisbane, Australia
- Centre for Online Health, The University of Queensland, Brisbane, Australia
| | - Jennifer L Rosenthal
- UC Davis School of Medicine, Sacramento, CA, USA
- Department of Pediatrics, UC Davis Health, Sacramento, CA, USA
- Center for Health and Technology, UC Davis Health, Sacramento, CA, USA
| | - Sarah C Haynes
- UC Davis School of Medicine, Sacramento, CA, USA
- Department of Pediatrics, UC Davis Health, Sacramento, CA, USA
- Center for Health and Technology, UC Davis Health, Sacramento, CA, USA
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