社区劣势与脆弱之间的关联:回顾性案例系列
David Fenton1, Amani Allen1, Johnathan R Kent2
1Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Journal of public health research
|June 13, 2024
概括
在贫困地区的手术患者更容易变得脆弱. 像区域贫困指数 (ADI) 和社会脆弱性指数 (SVI) 这样的地理空间指数确定了这种脆弱性风险的增加.
科学领域:
- 老年学和手术结果研究.
- 在临床实践中健康的社会经济决定因素.
背景情况:
- 虚弱是手术患者不良结果的预测因素.
- 社会经济地位显著影响手术患者的治疗结果.
- 像ADI和SVI这样的地理空间指数可以量化社区贫困.
研究的目的:
- 评估邻里贫困 (使用ADI和SVI) 与手术患者的脆弱性之间的关联.
- 确定社会经济地位的地理空间测量是否预测手术队列中的脆弱性.
主要方法:
- 对接受脆弱查的372名手术患者的回顾性分析 (12/2020-8/2022).
- 使用弗里德脆弱表型 (FFP) 和修改脆弱指数 (mFI-5) 评估脆弱性.
- 区域贫困指数 (ADI) 和社会脆弱性指数 (SVI) 基于患者居住地的四分位数;用于分析的后勤回归.
主要成果:
- 较高的贫困 (ADI/SVI四分位数) 与更多的并发病,较低的收入和增加的脆弱性相关 (p < 0.01).
- 在控制共变量后,脆弱性 (FFP) 与最贫困的ADI四分位数 (OR 2.61) 和SVI四分位数 (OR 2.33) 相关.
- 对于mFI-5分数 (≥2) 与ADI (OR 1.64) 和SVI (OR 1.71) 观察到类似的关联.
结论:
- 社会经济上贫困的社区与手术患者的脆弱性患病率更高有关.
- 地理空间指数有效地识别了患有脆弱性风险较高的手术患者.
- 有针对性的干预和资源分配可能对贫困地区的弱势群体有益.
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