非医疗特征影响推高级心力衰竭服务:回顾性审查
Catherine E Kelty1,2,3, Michael G Dickinson4, Rob Lyerla5
1Interdisciplinary Health Sciences PhD Program, Western Michigan University, Kalamazoo, MI, USA. catkelty@iu.edu.
Journal of racial and ethnic health disparities
|December 1, 2023
概括
社会和经济因素显著影响先进心力衰竭 (AHF) 患者的转诊和获得拯救生命的治疗方法,如心脏移植或左心室辅助装置 (LVAD) 植入. 解决这些差异对于公平的器官分配至关重要.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 患有晚期心力衰竭 (AHF) 的患者接受心脏移植或左心室辅助器件 (LVAD) 植入的严格评估.
- 获得这些先进疗法取决于最初的转诊,这可能会受到各种患者特定因素的影响.
- 本研究研究了AHF转诊,专家访问和治疗机会的社会经济和人口统计因素.
研究的目的:
- 研究社会和经济因素对高级心力衰竭 (AHF) 治疗的转诊过程的影响.
- 为了确定与获得心脏移植或左心室辅助器件 (LVAD) 评估的差异相关的患者特征.
- 了解影响随后的专家访问和AHF患者的治疗开始的因素.
主要方法:
- 在单一医院系统4年内对24,258名心力衰竭患者的回顾性评估.
- 对人口 (年龄,性别,种族/民族,语言),社会经济 (保险,婚姻状况) 和行为 (吸烟) 变量进行分析.
- 统计方法包括千平方,ANOVA,死亡率的逻辑回归,以及时间到事件的Cox比例危险模型.
主要成果:
- 年轻,男性和公共保险患者更有可能被转介到AHF护理.
- 未婚和吸烟的患者经历的转诊和诊所访问较少.
- 年轻,白人和西班牙裔/拉丁裔患者更有可能接受移植,而年长的西班牙裔/拉丁裔和吸烟患者面临更高的一年死亡率.
结论:
- 在预评估阶段,在获得高级心力衰竭 (AHF) 治疗方面存在显著差异.
- 年龄,性别,保险,婚姻状况,种族和吸烟行为等因素会影响转诊和治疗机会.
- 改善转诊和评估准入对于实现器官分配和AHF治疗中的公平至关重要.
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