在ED中,住房不安全的患者的特征和医疗保健利用情况
Madeleine A Z Ball1, Daniel E Sack1,2, Sophia A Druffner3
1Vanderbilt University School of Medicine, Nashville, Tennessee.
JAMA network open
|April 26, 2024
概括
5%的急诊室访问发现患者经历住房不安全. 这些患者经常表现出与自杀有关的担忧,没有保险,并经常访问,突出了针对性干预的需要.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 不稳定的住房和无家可归严重恶化了健康状况,增加了慢性疾病,伤害和残疾的风险.
- 紧急部门 (ED) 缺乏标准化的方法来识别面临无家可归风险或经历无家可归的人.
- 解决住房不安全问题对于改善患者健康和减少医疗保健差距至关重要.
研究的目的:
- 确定在城市急诊室寻求护理的患者中住房不安全的患病率.
- 分析住房不安全的患者的主要担忧,人口统计和医疗保健利用模式.
- 提供数据支持ED环境中对住房不安全的选工具和干预措施的实施.
主要方法:
- 一个横截面研究是在城市的三级护理,一级创伤中心进行的.
- 从2023年1月5日至5月16日期间向ED提交的成年患者收集了数据.
- 进行住房不安全查,主要结果包括阳性查的比例和检查患者特征和医疗保健使用的二次结果.
主要成果:
- 在23,795次ED访问中,5% (1,185次访问) 的查结果为无家可归或住房不安全呈阳性.
- 阳性查的患者更有可能是男性,没有保险,并且存在自杀或中毒的主要担忧.
- 查结果的阳性在夜间时间 (8点至6点) 更频繁,并且与多次急救诊所访问有关.
结论:
- 很大一部分城市急诊室的患者经历住房不安全,往往带来严重的健康问题.
- 这些发现强调了需要普遍查和量身定制的护理计划,以满足这一弱势群体的健康需求.
- 在ED中实施住房不安全查可以促进公平的医疗保健,并改善风险人群的健康结果.
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