选择性胆囊切除术的障碍在急诊室出院后,因为有症状的胆囊病
Joshua Gazzetta1, Rita Orjionwe1, Alyssa Fesmire1
1Saint Luke's Hospital of Kansas City, University of Missouri Kansas City School of Medicine, 4320 Wornall Road, Suite 530, Kansas City, MO, 64113, United States.
American journal of surgery
|July 27, 2024
概括
患有胆结石的患者通常会因为社会因素而推迟手术. 在急诊部 (ED) 解决健康的社会决定因素 (SDOH) 可以改善需要胆囊切除的弱势群体的结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗保健中的社会经济因素
- 外科手术的结果
背景情况:
- 症状性胆病常常导致急诊室 (ED) 的访问.
- 患者通常因选择性胆囊切除术而出院,但随访可能具有挑战性.
- 健康的社会决定因素 (SDOH) 可能会阻碍获得及时的外科护理.
研究的目的:
- 为了确定SDOH障碍,选择性胆囊切除术后ED释放.
- 评估这些障碍对患者治疗结果的影响.
- 为改善弱势群体手术接入的战略提供信息.
主要方法:
- 多机构,回顾性队列研究.
- 分析了患有症状胆病的患者从ED出院.
- 无变逻辑回归用于识别与ED重新呈现与选择性手术相关的因素.
主要成果:
- 缺乏初级保健医生,黑人种族,自雇身份,非英语初级语言和失业与ED重新呈现有关.
- 这些因素代表了获得选择性胆囊切除术的重大障碍.
- 随访护理方面的差异很明显.
结论:
- 社会弱势群体在选择性胆囊切除术方面遇到障碍.
- 在最初的ED呈现时进行手术可能会改善这些患者的结果.
- 将SDOH干预措施纳入ED护理途径是有必要的.
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