支气管炎临床途径对管理决策的影响,以首选语言为准
Robert H Rosen1, Michael C Monuteaux1, Anne M Stack1
1From the Division of Emergency Medicine, Boston Children's Hospital, Boston, Mass.
临床途径改善了所有患者的支气管炎护理. 然而,在非英语语的群体中,阿尔布特的使用率下降得更为显著,这表明药物管理中的潜在差异.
科学领域:
- 儿科急救医学 儿科急救医学
- 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:
- 临床途径旨在标准化医疗保健服务.
- 临床途径对医疗保健公平性的影响仍未得到充分研究.
- 这项研究研究了支气管炎路径对基于首选语言的管理决策的影响.
研究的目的:
- 评估支气管炎临床途径对医疗保健管理的影响.
- 为了确定该途径对管理决策的影响是否因患者对护理的首选语言而有所不同.
主要方法:
- 回顾性中断时间序列分析急诊室遇到1-12个月的肺炎患者的情况.
- 路径前 (10/2010-10/2011) 和路径后 (01/2012-10/2020) 时期的比较.
- 评估的结果包括胸部放射,阿尔布特罗尔使用,复诊,返回后入院,抗生素使用和皮质类固醇使用,根据慢性疾病进行调整.
主要成果:
- 整体使用胸部X光学,抗生素和阿尔布特罗尔降低了后路径实施.
- 临床途径对大多数结果的影响并没有因偏好的语言而有所不同.
- 值得注意的例外是阿尔布特罗尔的使用,在非英语首选语言患者中,与英语首选语言患者相比,这种情况的减少更大 (p=0.022).
结论:
- 实施的临床途径通常改善了对儿科支气管炎患者的护理,无论他们喜欢的语言如何.
- 虽然整体护理有所改善,但对阿尔布特罗尔利用的差异性影响要求对健康公平进行进一步调查.
- 建议在各种途径和环境中进行额外的研究,以充分了解对健康公平的影响.
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