与喘儿童可能不必要的转移相关的因素:一个回顾性队列研究
Gregory A Peters, Rebecca E Cash, Scott A Goldberg
1Department of Emergency Medicine, Massachusetts General Hospital.
Pediatric emergency care
|August 22, 2024
概括
医院和社区因素影响儿童喘患者不必要的设施间转移 (IFT). 更高的儿科患者数量和社区脆弱性与增加的潜在不必要的IFT相关,突出了护理差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 儿科急救医学 儿科急救医学
- 健康 公平 卫生 公平
背景情况:
- 设施间转移 (IFT) 是儿童喘恶化向急诊室 (ED) 呈现的常见情况.
- 潜在的不必要的IFT可能表明系统的低效率,并导致健康差异.
研究的目的:
- 确定与儿童喘患者潜在不必要的IFT率相关的医院和社区因素.
- 了解IFT实践在不同医疗保健机构和患者群体中变化的驱动因素.
主要方法:
- 分析加利福尼亚州ED数据 (2016-2019) 对于需要IFT的儿科喘恶化访问.
- 通过短期逗留 (<24小时) 和转移后没有高级服务来定义潜在的不必要的IFT.
- 利用多变量修改的波桑回归来评估医院/社区特征与IFT率之间的关联.
主要成果:
- 在325家被调查的医院中,近一半的医院有潜在的不必要的IFT率.
- 与较高率相关的因素包括儿科远程医疗的可用性,儿科患者数量的增加以及社区社会脆弱性指数的提高.
- 较高的儿科体积 (≥10,000次访问) 显示,不必要的IFT的患病率增加了2.6倍.
结论:
- 医院和社区因素对儿童喘患者潜在的不必要的IFT有重大影响.
- 调查结果突出了各种社区在护理获取和转移适当性方面的潜在差异.
- 结果可以告知有针对性的干预措施,以优化儿科喘护理过渡,并减少不必要的转移.
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