食品不安全状况和COPD患者的医疗保健利用情况:一项回顾性研究
Kristine Mendoza1,2, Patricia Calero1, Caroline Etland1
1Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, CA, USA.
粮食不安全和无家可归与慢性阻塞性肺病 (COPD) 患者访问急诊室的增加有关. 解决健康的社会决定因素可以改善医疗保健利用率和结果.
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:
- 目前针对慢性病患者的政府计划主要侧重于临床因素和患者教育.
- 这些计划往往忽略了健康的可修改的社会决定因素,如粮食不安全和无家可归,这可能会影响医疗保健利用率.
- 需要评估社会因素对健康结果和医疗保健系统参与度的影响.
研究的目的:
- 调查粮食不安全与社会人口统计学变量之间的关系.
- 根据其粮食安全状况,评估慢性阻塞性肺病 (COPD) 患者在医疗保健利用,特别是急诊室访问和住院的差异.
主要方法:
- 通过使用854名被诊断患有COPD的患者的电子健康记录进行了一项描述性,回顾性,横截面研究.
- 通过千平方测试,t测试和多变量逻辑回归来分析数据,以确定与急诊室访问和住院相关的因素.
- 参与者来自南加利福尼亚州医院的急诊室.
主要成果:
- 在食物不安全,年龄,种族,医疗保险,邮政编码,无家可归状态和吸烟状态方面,观察到群体之间的显著差异.
- 报告粮食不安全的患者显示,与急诊室访问的增加有显著的关联 (P=.033).
- 在食物不安全和食物安全的COPD患者之间,没有发现住院时间的显著差异 (P=.592).
结论:
- 这项研究强调了健康上游社会决定因素 (粮食不安全,无家可归,邮政编码) 与下游健康结果 (如重复访问急诊室) 之间的关联.
- 研究结果表明,解决社会因素对于有效减少医疗保健利用率和改善患者结果至关重要.
- 现有的医疗保健计划可以通过结合对健康的社会决定因素的干预来影响健康结果.
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