儿童机会指数和儿童医院的低价值护理
Irma T Ugalde1, Alan R Schroeder2, Jennifer R Marin3
1Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, Texas.
Pediatrics
|September 9, 2024
概括
通过童年机会指数 (COI) 衡量健康的社会驱动因素与儿科低价值护理 (LVC) 相对应. 较高的COI得分与LVC增加的可能性有关,尽管COI较低的地区绝对数量更高.
科学领域:
- 儿科医疗保健研究 儿科医疗保健研究
- 卫生公平研究 卫生公平研究
- 健康分析的社会决定因素分析
背景情况:
- 关于儿童群体中健康和低价值护理 (LVC) 的社会驱动因素之间的联系的研究有限.
- 儿童机会指数 (COI) 2.0是社会经济背景的衡量标准,可以反映健康的社会驱动因素.
研究的目的:
- 调查童年机会指数 (COI) 2.0与儿科低价值护理 (LVC) 的流行之间的联系.
- 确定在不同机会水平的地区的儿童医院遭遇是否表现出不同程度的LVC.
主要方法:
- 在2021年7月至2022年6月期间使用儿科健康信息系统LVC计算器应急和住院治疗.
- 在最高和最低的COI五分位数中比较LVC比例.
- 使用通用估计方程逻辑回归来分析COI五分位数中的LVC趋势.
主要成果:
- 分析包括20个LVC措施中的842,463次遭遇.
- 随着COI五分位数 (aOR1.06) 的提高,LVC的几率通常会增加.
- 对于10项措施,随着COI的增加,LVC的可能性增加;婴儿的胃酸抑制显示出最强的关联 (aOR 1.22).
- 相反,3项测量结果显示LVC降低,COI较高,小孩A组链球菌检测率最低 (aOR为0.85).
- 在大多数措施中,LVC的绝对体积在较低的COI五分位数中更大.
结论:
- 在大多数研究措施中,儿童低价值护理 (LVC) 的可能性在较高的童年机会指数 (COI) 五分位数中增加.
- 虽然可能性各不相同,但在所有COI级别中观察到高绝对量的LVC,这表明需要广泛的撤销战略.
- 建议优先考虑对影响低机会地区儿童不成比例的措施的取消实施.
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