用单一机构对高需要人口的选与全州范围的招生免费转移料相比
Francis Salvador Balucan1, Benjamin French2, Yaping Shi2
1Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN, 37212, USA. francis.g.balucan@vumc.org.
使用全州的入院,出院和转移 (ADT) 数据,这项研究发现,在范德比尔特大学医学中心 (VUMC) 识别急需患者时,选择偏差最小. 依靠单一机构的数据是评估患者获取公平性的可靠方法.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 医疗信息学 医疗信息学
背景情况:
- 对于急需的患者来说,获得护理计划往往依赖于单一机构的电子健康记录 (EHR) 数据,风险是有偏见的抽样.
- 全州录取,放弃和转移 (ADT) 数据为评估计划获取公平性提供了更广泛的视角.
研究的目的:
- 调查全州ADT料在评估获得高需要患者计划的公平性方面的实用性.
- 为了比较使用全州ADT数据与单一机构EHR数据的患者识别.
主要方法:
- 在田纳西州,从2021年1月1日至6月30日,对高需要患者 (≥18岁) 进行了回顾性横截面研究.
- 利用田纳西州ADT数据库和范德比尔特大学医学中心 (VUMC) Epic® EHR识别急需患者.
- 将仅VUMC的患者鉴定与全州ADT数据作为参考标准进行比较;主要结局是灵敏度.
主要成果:
- 通过全州ADT识别了2549名急需患者;2100人仅进行VUMC访问,449人进行VUMC和非VUMC访问.
- 仅VUMC的标准显示高灵敏度 (99.1%) 识别高需要的患者,表明很少访问替代系统.
- 敏感性分析显示,基于患者的种族或保险状况,没有显著差异.
结论:
- 全州的ADT数据使得对单一机构对高需要患者计划的利用中选择偏差的检查成为可能.
- 当VUMC依赖于同一地点的利用来识别急需患者时,观察到最小的选择偏差.
- 需要进一步的研究,以了解不同地点和时间的偏差差异.
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