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Expanding the Safety Net of Specialty Care for the Uninsured: A Case Study
Author(s) -
Spatz Erica S.,
Phipps Michael S.,
Wang Oliver J.,
Lagarde Suzanne,
Lucas Georgina I.,
Curry Leslie A.,
Rosenthal Marjorie S.
Publication year - 2012
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2011.01330.x
Subject(s) - specialty , safety net , participatory action research , community based participatory research , nursing , business , medicine , medical education , public relations , family medicine , political science , environmental health , sociology , anthropology
Objective To describe core principles and processes in the implementation of a navigated care program to improve specialty care access for the uninsured. Study Setting Academic researchers, safety‐net providers, and specialty physicians, partnered with hospitals and advocates for the underserved to establish P roject A ccess‐ N ew H aven ( PA ‐ NH ). PA ‐ NH expands access to specialty care for the uninsured and coordinates care through patient navigation. Study Design Case study to describe elements of implementation that may be relevant for other communities seeking to improve access for vulnerable populations. Principal Findings Implementation relied on the application of core principles from community‐based participatory research ( CBPR ). Effective partnerships were achieved by involving all stakeholders and by addressing barriers in each phase of development, including (1) assessment of the problem; (2) development of goals; (3) engagement of key stakeholders; (4) establishment of the research agenda; and (5) dissemination of research findings. Conclusions Including safety‐net providers, specialty physicians, hospitals, and community stakeholders in all steps of development allowed us to respond to potential barriers and implement a navigated care model for the uninsured. This process, whereby we integrated principles from CBPR , may be relevant for future capacity‐building efforts to accommodate the specialty care needs of other vulnerable populations.