在接受上肢整形手术的患者中,违背医疗建议离开的风险因素
David Momtaz1, Umar Ghilzai, Shawn Okpara
1From the UT Health San Antonio, Department of Orthopaedics, San Antonio, TX (Mr. Momtaz, Mr. Gonuguntla, Mr. Kotzur, Mr. Zhu, Dr. Seifi, and Dr. Rose), and the Baylor College of Medicine, Department of Orthopaedics, Houston, TX (Dr. Ghilzai, Dr. Okpara, and Dr. Ghali).
概括
在上肢整形手术后违背医疗建议 (AMA) 离开的患者更有可能是年轻人,黑人,男性,并受医疗补助保险. 这些患者还经历了更长的住院和康复时间,这表明在护理方面存在潜在的差异.
科学领域:
- 整形外科手术 整形外科手术
- 医疗保健服务研究 医疗服务研究
- 患者的治疗结果.
背景情况:
- 违背医疗建议离开 (AMA) 对患者健康构成重大风险,并对医疗保健系统构成挑战.
- 了解与AMA出院相关的因素对于改善患者安全和护理质量至关重要,特别是在外科手术后.
研究的目的:
- 确定与患者在上肢 (UE) 骨科手术后违背医疗建议 (AMA) 出院相关的人口统计和医院过程因素.
- 为了比较离开AMA的患者与按计划完成治疗的患者的特征.
主要方法:
- 对一个大型的国家数据库 (医疗保健成本和利用项目) 的分析,该数据库涵盖了2011年至2020年接受UE整形手术的262,912名患者.
- 在离开AMA和没有离开AMA的患者之间,对人口统计学变量 (年龄,种族,性别,保险,收入) 和医院疗程因素 (住院时间,康复时间) 的比较分析.
主要成果:
- 一小部分 (0.45%) 的UE骨科患者离开了AMA.
- 30-49岁的患者,黑人患者,有医疗补助保险的人以及收入最低四分之一的个人显示出离开AMA的几率明显更高.
- 女性患者离开AMA的可能性较小,而离开AMA的患者住院时间和康复时间较长.
结论:
- 特定的人口群体,包括年轻男性,黑人患者,医疗补助受益者和低收入人群,在UE整形外科手术后离开AMA的患者中占比不大.
- 这些发现强调了医疗保健的潜在差异,以及需要针对性干预措施,以满足脆弱患者群体的需求,以减少AMA出院.
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