紧急部门桥梁模型和健康服务在阿片类药物使用障碍患者中使用
Mirsada Serdarevic1, Matthew Cvitanovich1, Brooke R MacDonald1
1Center for Epidemiology and Healthcare Delivery Research, JPS Health Network, Fort Worth, TX.
桥梁诊所转诊在急诊室的阿片类药物使用障碍患者显著改善了长期护理联系. 然而,对住院患者入院的影响各不相同,特别是对那些患有严重精神疾病的人来说,这表明潜在的未满足需求.
科学领域:
- 公共卫生 公共卫生
- 紧急医疗 紧急医疗
- 成 药物 药物 药物 药物
背景情况:
- 桥梁诊所对阿片类药物使用障碍 (OUD) 过渡性护理从急诊室 (ED) 的有效性尚未研究.
- 在ED的OUD患者需要有效的过渡期护理策略.
研究的目的:
- 评估桥梁诊所转诊对OUD患者在ED中确定的医疗服务利用的影响.
- 评估桥梁诊所干预对长期护理,ED使用和住院入院的联系的影响.
主要方法:
- 在ED接受药物治疗的18岁以上有活性OUD的患者的回顾性分析 (2013年1月至2022年8月).
- 干预组:患者转诊到桥梁诊所 (2021年1月起). 对照组:接受常规护理的患者 (2021年1月之前) 的倾向性得分匹配.
- 使用风险差异对120天内结果进行比较 (与长期护理的联系,ED使用,住院治疗).
主要成果:
- 桥梁诊所转诊使长期护理的联系增加了25% (95% CI: 20%, 30%).
- 随着桥梁诊所转诊,ED使用风险增加了7.5% (95%CI:1.6%,13%).
- 总体而言,住院住院风险略有下降 (-1.9%,95% CI: -5.9%,2.1%),但在患有严重精神疾病的患者中增加,而在没有严重精神疾病的患者中降低.
结论:
- 桥梁诊所转诊有效地加强了对OUD患者从EDs的长期护理的联系.
- 对患有或没有严重精神疾病的患者住院住院的不同影响凸显了具体的需求和护理的潜在差距.
- 需要进一步调查严重精神疾病的OUD患者的未满足需求.
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