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新诊断的抑郁症患者在急诊室利用率中的种族差异
Frank Müller1, Akhilesh Munagala2, Judith E Arnetz2
1Department of Family Medicine, Michigan State University, Grand Rapids, MI, USA; Corewell Health Family Medicine Residency Clinic, Grand Rapids, MI, USA; Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.
General hospital psychiatry
|November 5, 2023
概括
患有抑郁症的种族和民族少数群体更频繁地前往急诊室 (ED),即使有初级保健提供者. 与白人患者相比,黑人和美洲原住民患者的ED访问率明显高.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
- 主要护理是指初级护理.
背景情况:
- 种族和民族少数群体面临着严重的健康差异.
- 获得初级保健对于管理抑郁症等慢性疾病至关重要.
- 了解急诊室 (ED) 使用模式是解决医疗保健准入问题的关键.
研究的目的:
- 调查是否被诊断患有抑郁症的种族和民族少数群体的急诊室 (ED) 访问率更高.
- 为了确定已建立的初级保健提供者 (PCP) 关系是否会在患有抑郁症的少数群体中减轻ED使用.
主要方法:
- 追溯性队列研究分析了47家家庭医学诊所的电子病历 (EMR) 数据.
- 纳入标准:在12个月内新诊断PCP发行的抑郁症患者.
- 统计分析:使用波松分布的一般线性回归模型来预测ED访问频率.
主要成果:
- 分析包括4159名患者.
- 与白人/高加索人患者相比,黑人/非洲裔美国患者的ED访问次数增加了0.90次 (95% CI为0.64,1.16).
- 与白人/高加索人患者相比,美国印第安人/阿拉斯加土著患者的急救诊所访问次数增加了1.39次 (95%CI为0.92,1.87).
结论:
- 患有抑郁症的黑人/非裔美国人和美国印第安人/阿拉斯加原住民患者使用ED的可能性明显高于白人/高加索患者.
- 尽管建立了初级保健关系,这种使用ED的增加仍然存在.
- 调查结果突出了少数群体在医疗保健获取和使用抑郁症管理方面的持续差异.
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