在高血压患者中共享决策和急救部门的使用
R Aver Yakubu1,2, Alyssa Coleman1, Alina Ainyette1
1Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri.
Preventing chronic disease
|September 21, 2023
概括
与提供者参与共享决策的高血压患者不太可能访问急诊室 (ED). 这一发现强调了共享决策作为减少高血压管理医疗保健利用的战略.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 患者与医疗服务提供者之间的沟通
- 公共卫生 公共卫生
背景情况:
- 高血压影响了近一半的美国成年人,在急诊室 (ED) 用户中普遍存在.
- 患者坚持治疗对于管理高血压和减少ED访问至关重要.
- 共享决策 (SDM) 是一种沟通策略,可以提高患者的坚持.
研究的目的:
- 调查高血压成年人中共享决策与急诊室使用之间的联系.
- 确定增强的患者-提供者沟通是否可以减少高血压管理中的医疗保健利用率.
主要方法:
- 一项采用2015-2019医疗支出小组调查数据进行的横截面观察性研究.
- 基于现有文献,开发了一个共享决策的预测变量.
- 多变量逻辑回归分析了30407名成年人样本中SDM和ED使用之间的关联.
主要成果:
- 只有39.3%的受访者报告了高水平的共享决策.
- 报告高SDM的患者在急救诊所访问的可能性降低了20% (未调整的OR,0.80).
- 即使经过对共变量进行调整,高SDM仍然与使用ED的几率较低有关 (调整后OR,0.86).
结论:
- 共享决策显示出作为减少高血压患者急诊室访问的有效策略的潜力.
- 促进SDM可以提高治疗坚持和降低与高血压相关的医疗保健费用.
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