123. The ABC of Primary Care For University And College Students: A Three-Step Structured Approach At The Geneva University Hospitals, Switzerland
Journal of Adolescent Health(2019)
摘要
University and college students represent a population of 18,000 people in Geneva, Switzerland. They present specific health issues with vulnerabilities related to mental health, sexual health, risk-taking behaviors and delayed access to primary care. A new outpatient general medicine clinic for students was created in September 2016 at the Geneva University Hospitals with the goal of answering their specific health needs. With this paper, we present the guideline developed to address these needs and the evaluation of students’ satisfaction with this innovative model. Our student health assessment guideline was elaborated through different sources involving literature reviews, experts, local hospital guidelines and through a consensus between 14 professionals from Geneva University Hospitals and its network. It was then validated by the committee in charge of clinical strategies at the Primary Care Division of Geneva University Hospitals. An online evaluation available in French or English was accessible after each consultation for students attending our services. Our health assessment proposes 3 steps: A) General information (reason for consultation, medical history, participation to trials, allergies, and treatment); B) social evaluation (academic background, social network, health care providers, personal resources, gender identity and sexual orientation) and C) preventive care (vaccinology, diet, dental and ophthalmic care, risk taking with sports and vehicles, product taking, internet and new technologies, gambling, violence, mental health, sexual health and gynecology). A pre-requisite is to be responsive to the student’s main request and then to explore student’s knowledge about health insurance system in order to inform about and anticipate the financial implications of health care. The importance of offering modern means of communication was underlined by experts. In June 2018, 86 students answered the online- evaluation form. They especially appreciated the time taken for a first consultation (45 minutes on average) and the relevance of questions asked about their health and lifestyle. More than 94% of them agree or totally agree to recommend our consultation to fellow students and intend to be followed-up at our consultation. Around 90% of them feel we adequately address their specific students-related issues. A specific approach is needed in primary care for university and college students. It requires specific competences in a number of domains: adolescent medicine, internal medicine, mental health, gynecology, pediatrics, vaccinology and addictology. Through our 3-step structured approach, we intend to cover the main health issues encountered by students and wish to improve their health management. We focused our approach on students, yet most of the approach described could benefit to young adults in general. Further research on outcomes related to this approach is needed, as well as research comparing our approach to other tools used in practice.
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关键词
geneva university hospitals,primary care,college students,three-step
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