在美国,不受控制的严重喘患者的护理缺口
Tara Carr1, Joseph Tkacz2, Yen Chung3
1Department of Medicine, University of Arizona, Tucson, Ariz.
The journal of allergy and clinical immunology. In practice
|March 20, 2024
概括
许多严重喘患者没有得到专家护理或药物调整. 这凸显了差异和需要更好地执行指南,特别是针对少数群体的人口.
科学领域:
- 肺部病理学 肺部病理学
- 医疗保健服务研究 医疗服务研究
- 现实世界的证据.
背景情况:
- 管理严重喘 (SA) 需要遵守对不受控制的疾病的指导方针建议.
- 了解治疗差距对于改善患者的治疗结果至关重要.
研究的目的:
- 评价美国SA患者的专家访问和药物升级,以后的事件表明不受控制的疾病 (EUD).
- 检查这些干预措施,健康结果和社会差异之间的关联.
主要方法:
- 对SA患者的行政索赔数据 (2015-2020年) 的回顾性分析.
- 患者根据EUD (住院治疗,ED/用系统性皮质激素治疗的门诊诊) 进行了分类.
- 在EUD和对照组之间比较结果 (专家访问,药物升级,恶化),分析社会差异指标.
主要成果:
- 确定了超过18万名SA患者;35-51%的EUD缺乏专家访问或药物升级.
- 随访恶化在EUD队列 (4-51%) 与对照 (13%).
- 与非西班牙裔白人患者 (33%) 相比,黑人和西班牙裔/拉丁裔患者的非专家访问/药物升级率更高 (41%,38%).
结论:
- 很大一部分不受控制的SA患者没有接受EUD后推的专家护理或药物调整.
- 无法控制的疾病与增加的医疗保健利用率和恶化严重相关.
- 需要改进基于指导方针的护理服务,特别是解决SA管理中的社会差异.
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