在退伍军人护理文件的术前目标的差异
Adela Wu1,2, Karleen F Giannitrapani1,3, Ariadna Garcia1,4
1VA Health Services Research and Development Center for Innovation to Implementation, VA Palo Alto Health Care System, U.S. Department of Veterans Affairs, Palo Alto, California.
JAMA network open
|December 19, 2023
概括
护理文件的手术前目标对于女性,黑人,西班牙裔和农村退伍军人以及那些有精神健康残疾史的人来说不太常见. 这些差异在不同级别的医疗保健设施中仍然存在.
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
- 手术护理 手术护理
背景情况:
- 护理讨论的术前目标对于管理手术压力和风险至关重要.
- 了解影响这些讨论的因素对于公平的患者护理至关重要.
研究的目的:
- 检查退伍军人之间的护理文档手术前目标的差异.
- 评估种族,种族,精神健康史和设施特征对记录率的影响.
主要方法:
- 在2017-2022年期间,退伍军人医疗管理局 (VHA) 接受了229,737名退伍军人手术的回顾性横截面研究.
- 分析患者层面的因素 (种族,种族,并发症,精神健康史) 和系统层面的因素 (设施复杂性).
- 逻辑回归用于估计维持生命治疗 (LST) 的概率比率 (OR) 和95%置信区间 (CI).
主要成果:
- 只有5.8%的退伍军人完成了手术前的LST文件.
- 在女性,黑人,西班牙裔和农村退伍军人以及那些有精神健康残疾史的人群中,观察到较低的记录率.
- 复杂性较低的设施中的患者的记录率明显较低.
- 尽管存在COVID-19大流行,但随着时间的推移,LST的记录率有所增加.
结论:
- 在退伍军人中,护理文件的术前目标仍然存在显著差异.
- 包括种族,种族,乡村,精神健康史和设施类型在内的因素与这些差异有关.
- 解决这些差异对于确保所有退伍军人获得公平的外科护理至关重要.
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