烧伤中心验证和安全网状态:出院与住院康复有没有区别?
Devi Lakhlani1, Samantha Steeman1, Eloise W Stanton2
1Stanford Department of Surgery, Stanford University School of Medicine, Stanford, CA 94301, USA.
概括
严重烧伤后急性康复的出院因患者的种族和保险而异. 经过验证的烧伤中心和安全网设施改善了烧伤患者入院康复的机会.
科学领域:
- 烧伤伤害康复 烧伤伤害康复
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
背景情况:
- 获得急性康复治疗的机会,对于恢复和生活质量至关重要.
- 现有的研究表明,基于种族和支付者类型,康复机会存在差异.
- 燃烧中心组织因素对这些排放差异的影响尚不清楚.
研究的目的:
- 调查患者人口统计,烧伤中心特征和急性康复出院之间的关联.
- 检查人口层面的数据,以确定影响入院治疗严重烧伤患者康复的因素.
主要方法:
- 在加利福尼亚州 (2009-2019) 经过验证和未经验证的烧伤中心使用加利福尼亚医疗保健访问和信息数据库分析住院患者的遭遇.
- 主要结局:急性康复治疗后出院的患者比例.
- 统计分析包括后勤回归和混合效应建模,调整年龄,种族,支付人,烧伤严重程度,美国烧伤协会 (ABA) 验证状态和创伤中心指定等共变量.
主要成果:
- 在27,496次遭遇中,只有0.8%的患者被送往住院康复中心.
- 出院率因种族/种族而异 (白人0.9%,黑人0.6%,西班牙裔0.7%,亚裔1%).
- 释放到康复的关键预测因素包括医疗保险支付人身份 (较低的几率),创伤中心状态,ABA验证和安全网设施状态 (更高的几率),经过对烧伤严重程度和人口统计进行调整后.
结论:
- 在重大烧伤伤害后入院康复的出院受到患者的种族,支付人身份和烧伤中心特征的影响.
- 经过验证的烧伤中心和安全网设施表明,出院患者进入住院康复的可能性更高.
- 这些发现强调了需要解决烧伤中心内的系统因素,以减少康复机会的差异.
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