枪伤后被送往熟练护理机构的相关因素
Anthony Eze1, Harold Leraas1, Oluebubechukwu Eze1
1Division of Trauma Critical Care and Acute Care Surgery, Duke University Department of Surgery, Durham, North Carolina.
The Journal of surgical research
|October 18, 2023
概括
枪伤的黑人患者更有可能被送往家庭医院,而白人患者更有可能去熟练的护理机构. 枪支伤害幸存者的急性治疗后的这种差异凸显出需要公平的出院计划.
科学领域:
- 公共卫生 公共卫生
- 创伤外科 手术 创伤外科
- 健康差异 在健康上的差异
背景情况:
- 枪支伤害是一个重要的公共卫生问题,不成比例地影响服务不足地区的少数群体.
- 评估枪支伤害的全部影响需要超越死亡率,包括生存和退院后的护理.
- 枪伤 (GSW) 幸存者的排放处置对于恢复至关重要,并且可以反映潜在的系统偏见.
研究的目的:
- 调查因枪伤 (GSW) 相关创伤而接受治疗的患者中种族,保险状况和出院倾向之间的关联.
- 确定影响GSW幸存者的急性护理后安置的人口统计和受伤相关因素.
主要方法:
- 利用2019年创伤质量改善计划数据库识别GSW患者的AIS分数为1-3的GSW患者.
- 不包括在医院死亡或在家常出院的患者.
- 采用多变量后勤回归来分析与出院处置相关的因素,控制人口统计数据,受伤严重程度和停留时间.
主要成果:
- 与白人患者相比,黑人患者在家庭卫生服务下更有可能在家出院 (64.1%vs34.7%).
- 与黑人患者相比,白人患者出院到熟练护理机构 (SNF) 的可能性更高 (51.4%与44.6%相比).
- 独立地与SNF退役相关的因素包括年龄较大,医疗补助或医疗保险,以及逗留时间较长.
结论:
- 枪伤幸存者在急性治疗后的安置中存在显著的种族差异.
- 黑人枪伤受害者更常被送往家庭医院,而白人患者更常被送往SNF.
- 需要有针对性的干预措施来解决公平后期护理的障碍,并改善受枪支伤害影响的弱势群体的结果.
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