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健康和败血症的社会决定因素:一个病例控制研究
Fatima Sheikh1,2,3, William Douglas4, Yi David Diao4
1Department of Health Research Methods, Evidence and Impact (HEI), Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada. sheikf9@mcmaster.ca.
概括
健康的社会决定因素 (SDoH) 数据在健康记录中缺乏. 贫困社区的个人有更高的败血症率和死亡率,尽管SDoH数据的可用性有限.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 健康 公平 卫生 公平
背景情况:
- 健康的社会决定因素 (SDoH) 显著影响健康结果.
- 了解SDoH对于解决健康差异至关重要,特别是在感染性疾病 (如败血症) 中.
- 电子健康记录 (EHR) 往往缺乏全面的SDoH数据,阻碍了研究和有针对性的干预.
研究的目的:
- 调查SDoH和败血症发展之间的关联.
- 为了比较败血症发病率和结果在系统地处于劣势的邻里和其他人.
- 突出将SDoH数据集成到EHR中的必要性.
主要方法:
- 一个单一中心的病例控制研究,涉及300名成年患者 (100名有败血症,200名没有).
- 收集的数据包括人口统计和有限的SDoH变量 (收入,吸烟,社会支持,酒精障碍病史).
- 多变量逻辑回归模型用于数据分析.
主要成果:
- 与败血症相关的因素包括救护车的到来,缺乏家庭医生,更高的早期预警分数和失脂病史.
- 个人/家庭收入和种族等关键的SDoH数据在医疗图表中缺失.
- 没有可用的SDoH变量显示出与败血症有显著的关联.
- 败血症病例和死亡人数与其人口代表性相比,在系统不利的社区中大约是两倍.
结论:
- 电子健康记录缺乏重要的SDoH数据,阻碍了对败血症风险的全面分析.
- 尽管数据有限,但贫困社区的个人体验过不成比例地更高的败血症和败血症相关死亡率.
- 将SDoH整合到EHR中对于了解败血症风险和促进健康公平至关重要.
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