宾夕法尼亚州东南部的医疗补助覆盖和急救部门利用情况
Olusegun Bakare1, Ikeoluwa A Akintujoye2, Paul E Gbemudu1
1Internal Medicine-Pediatrics, Tulane University School of Medicine, New Orleans, USA.
Cureus
|October 20, 2023
概括
紧急部门 (ED) 的过度利用率在美国的医疗补助接收者和少数群体中很高. 解决这一问题需要改善弱势群体获得初级保健的机会.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 患有非紧急情况的患者在急诊室 (ED) 过度使用是美国的一个重大问题.
- 这种趋势加剧了医疗保健成本,并在昂贵的美国医疗保健系统中压缩了资源.
- 在有医疗补助覆盖的个人中,特别是在"平价医疗法案"扩大后,特别注意到过度利用.
研究的目的:
- 确定与急诊室 (ED) 过度利用相关的人口和社会经济因素.
- 量化医疗补助受益人身份和急救诊所访问之间的关系.
- 为减少非出现性ED使用和改善初级保健准入的战略提供信息.
主要方法:
- 利用了2018年南东宾夕法尼亚州 (SEPA) 家居健康调查的数据.
- 采用双变量分析来确定ED访问的重要预测变量.
- 应用多变量逻辑回归来根据各种因素确定ED呈现的几率.
主要成果:
- 医疗补助受益人显示,急救诊所访问的几率明显更高 (OR: 2.863).
- 与白人相比,黑人 (OR: 1.647) 和美洲原住民 (OR: 2.985) 个体使用ED的几率更高.
- 教育程度较低,贫困率低于150%的贫困水平,失业率也与使用ED的增加有关.
结论:
- 人口和社会经济因素,包括医疗补助地位,种族,教育,贫困和就业,与急诊室 (ED) 过度利用密切相关.
- 需要有针对性的干预措施,以改善弱势群体获得初级保健,以减轻ED过度使用.
- 要解决ED过度利用的复杂问题及其对医疗保健成本和效率的影响,必须采取多方面的方法.
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