形成性评估和无家可归者的集群成员身份 紧急情况部门访问
Gesulla Cavanaugh1, Patrick Hardigan2, Raymond Ownby3
1College of Nursing, Nova Southeastern University, Davie, USA.
Cureus
|August 12, 2024
概括
无家可归者和私人家庭中患有多种并发症或药物滥用的人更有可能重复访问急诊室 (ED). 集群分析可以识别这些群体进行有针对性的医疗干预.
科学领域:
- 公共卫生 公共卫生
- 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:
- 只有有限的证据可以比较在急诊室 (ED) 的无家可归者的临床特征与需要紧急护理的私人家庭的临床特征.
- 对于无家可归人口的适当医疗保健和紧急医疗服务,知识差距仍然存在.
- 了解这些差异对于开发针对无家可归患者的有针对性的干预措施至关重要.
研究的目的:
- 为医院提供一个框架,为无家可归患者开发有针对性的干预措施.
- 通过考虑行为,健康和社会特征来改善医疗保健服务.
- 为了更好地满足ED中不同患者群体的医疗保健需求.
主要方法:
- 利用了来自国家医院门诊医疗调查 (NHAMCS) 数据库 (2013-2016) 的数据.
- 分析了85,350名患者的病历,根据居住地分类:私人,养老院或无家可归.
- 采用集群分析和名义回归来识别患者特征并预测ED访问的复发.
主要成果:
- 集群分析显示,具有多种并发症和药物滥用/依赖症的个体更容易在72小时内再次访问急救中心,而不论居住地.
- 标称回归表明,集群成员预测了患者的居住地.
- 药物滥用和抑郁症被确定为72小时ED访问复发的预测因素.
结论:
- 集群分析可以揭示紧急部门内的社会健康和群体特征.
- 这些分析支持开发针对患者个体需求和群体特异性量身定制的有针对性的医疗保健解决方案.
- 这些发现可以为优化对弱势群体 (包括无家可归者) 的紧急护理策略提供信息.
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