在全国代表性样本中,最近无家可归的成年人中使用急诊室
Caitlin Ryus1, Elina Stefanovics2,3, Jack Tsai3,4,5
1Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut.
The western journal of emergency medicine
|October 3, 2023
概括
当考虑社会和健康因素时,无家可归与急诊室 (ED) 使用没有显著联系. 解决社会劣势和健康问题是ED服务提供的关键.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 无家可归是一个重要的公共卫生问题.
- 在弱势群体中,急救部门 (ED) 的利用率往往更高.
- 无家可归和ED使用之间的关系需要检查潜在的社会和健康因素.
研究的目的:
- 为了调查无家可归和急诊室 (ED) 使用之间的关联.
- 确定社会,医疗和心理健康因素在多大程度上调解了这种联系.
- 测试假设社会劣势解释了无家可归和ED使用之间的许多联系.
主要方法:
- 采用了来自全国酒精和相关疾病流行病学调查 (NESARC-III) 的数据.
- 紧急部门的使用被分类为没有,中度 (1-4次访问) 和高 (5+次访问).
- 采用多变量调整后勤回归来分析关联,控制社会人口统计学,医学和心理健康变量.
主要成果:
- 未经调整的分析显示,无家可归与中度/高度使用ED之间存在很强的关联 (OR 2.31,7.34).
- 在调整了社会人口统计因素后,相关性显著下降 (AOR 1.27,1.62).
- 进一步调整医疗/心理健康变量,并包括所有因素在内的最终模型,显示无家可归与ED使用之间没有统计学上显著的关联.
结论:
- 无家可归与ED使用之间的初始关联在很大程度上可以通过社会劣势和健康问题来解释.
- 考虑到这些因素,无家可归本身并不是ED使用的重要预测因素.
- 提供ED服务的策略应该全面地解决无家可归者的健康状况和健康的社会决定因素.
相关概念视频
Specialized Care Centers and Settings-II
749
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
749
PPE Use in Healthcare Settings II: Doffing
943
The sequence of removing or doffing PPE starts with the gloves, as they are the most contaminated. Next is removal of the face shield or goggles, as they would interfere with removing other PPE. Then remove the gown, followed by the mask or respirator. Perform hand hygiene between steps if hands become contaminated and immediately after removing all PPE. Generally, the outside front and sleeves of the isolation gown, the goggles or the mask, the respirator, and the face shield are contaminated.
943
Documentation in Long-Term and Home Healthcare Setting
909
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
909
Healthcare Agencies II
717
There are various healthcare agencies in the United States—some of which are managed by religious institutions and others by different government branches.
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources,...
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources,...
717
Adrenergic Agonists: Therapeutic Uses
835
Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
835
Bystander Effect
9.6K
The discussion of bullying highlights the problem of witnesses not intervening to help a victim. This is a common occurrence, as the following well-publicized event demonstrates. In 1964, in Queens, New York, a 19-year-old woman named Kitty Genovese was attacked by a person with a knife near the back entrance to her apartment building and again in the hallway inside her apartment building. When the attack occurred, she screamed for help numerous times and eventually died from her stab wounds.
9.6K


