COI与过度医疗保健利用和ACSCC成本之间的关联
Danielle Maholtz1,2, Christopher K Page-Goertz1,2, Michael L Forbes1,3,2
1Division of Critical Care Medicine, Department of Pediatrics.
较低的邻里机会与更多的儿童住院治疗门诊护理敏感条件 (ACSC) 有关. 这种不平等导致了数十亿美元的过度医疗费用和数百例可预防的死亡.
科学领域:
- 儿科健康 儿科健康
- 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:
- 以前的研究将童年机会指数 (COI) 与更高的门诊护理敏感条件 (ACSC) 住院率联系起来.
- 这种健康不平等对医疗保健系统的财务和资源负担在很大程度上仍未得到量化.
研究的目的:
- 量化与较低社区机会相关的过度医疗保健资源利用和成本.
- 分析不同COI层的儿童中与ACSC相关的过度住院,住院日数和财务支出.
主要方法:
- 使用儿科健康信息系统数据库 (2016-2022) 进行回顾性横截面研究.
- 包括18岁以下儿童住院住院的情况.
- 根据COI水平分层的ACSC住院,死亡率和成本的比较.
主要成果:
- 分析了超过280万例住院病例,其中44.5%为ACSC.
- 在COI非常低层的儿童中,与COI非常高层 (39.7%) 相比,潜在可预防的ACSCC住院比例更高 (49.1%).
- 较低的COI与可预防住院的几率增加有关 (OR 1.18). 额外的住院费用为13亿美元,死亡人数为813人,主要在COI最低层.
结论:
- 居住在机会较低的社区的儿童面临ACSC住院的风险更大.
- 儿童机会指数可以确定有针对性的干预措施可以有效地减少医疗保健利用率和相关成本的社区.
- 通过专注于社区机会的倡议,解决健康的社会决定因素对于减轻儿科健康差异和医疗保健支出至关重要.
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