医疗补助保险预测,长期接受阿片类药物治疗的患者中,术后护理接触增加
Limi Sharif1,2, Caroline S Zubieta1, Akul Arora1
1University of Michigan Medical School, Ann Arbor, MI.
Annals of surgery
|March 14, 2024
概括
与私人保险患者相比,有医疗补助保险的患者在手术后有更多的无计划的术后护理. 这凸显了长期使用阿片类药物治疗的个人在护理方面的潜在差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 健康 公平 卫生 公平
背景情况:
- 手术前的长期阿片类药物治疗具有独特的风险和较差的外科治疗结果.
- 保险覆盖对这些患者的术后结果的影响尚不清楚.
研究的目的:
- 调查保险类型 (医疗补助与私人) 与非计划的术后护理遭遇之间的关联.
- 分析长期服用阿片类药物治疗,接受腹膜外科手术的患者的治疗结果.
主要方法:
- 该研究包括在密歇根州 (2017-2021) 手术前>120天或>=10个阿片类药物处方的患者.
- 主要结局:无计划的护理遭遇 (ED访问或30天内再入院).
- 多变量后勤回归分析了保险类型对急性护理事件的影响.
主要成果:
- 分析了1212名患者,45.6%的人有医疗补助计划.
- 在8名患者中,有1名患者经历了无计划的术后护理.
- 医疗补助患者有4.5个百分点更高的意外遭遇概率 (95%CI:0.5%,8.4%).
结论:
- 与长期阿片类药物治疗的私人保险患者相比,Medicaid患者的非计划性护理遭遇更为频繁.
- 研究结果表明,与健康的社会决定因素相关的潜在差异.
- 术后护理策略可能需要为脆弱人群解决这些已识别的缺口.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
289
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
289
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
80
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
80
Analgesia and Pain Management
614
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
614
Opioid Analgesics: Morphine and Other Natural Cogeners
244
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
244
Restorative Care
2.0K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
2.0K
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
196
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
196


