在急诊室的无家可归患者中,测试结果正在等待出院
Kathleen Joseph1, Fanni Cardenas2, Risa Brudney2
1Department of Emergency Medicine, Denver Health Medical Center, Denver, CO, United States of America; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America; Colorado Social Emergency Medicine Collaborative, Denver, CO, United States of America.
The American journal of emergency medicine
|September 15, 2024
概括
无家可归者 (PEH) 面临着严重的障碍,无法与待出院的测试结果 (TPAD) 进行沟通. 需要创新的解决方案来提高接触率,并确保这种脆弱人群得到适当的医疗治疗.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
背景情况:
- 无家可归者 (PEH) 是一个脆弱的患者群体,同时出现的疾病和死亡率很高.
- 有效沟通的测试结果等待在出院 (TPAD) 是关键的后急诊部 (ED) 护理连续性.
- PEH往往缺乏一致的后续护理,加剧了健康差异.
研究的目的:
- 检查与住院患者相比,患有TPAD的PEH的电话接入,成功联系和治疗变化.
- 为了识别沟通和护理PEH从ED释放的差异.
- 为改善弱势群体出院后护理的策略提供信息.
主要方法:
- 在安全网医院7个月内对异常TPAD和患者电话笔记进行回顾性队列研究.
- 从电子健康记录中提取的数据,包括电话访问,成功联系和推的治疗变化.
- 多变量后勤回归用于评估无家可归,联系和电话接入之间的关联,根据年龄和性别进行调整.
主要成果:
- 与PEH相比,住院患者更有可能获得电话接入,并与TPAD成功联系.
- 无家可归与成功联系和电话接入的减少密切相关 (OR分别为0.16和0.11).
- 患有TPAD的PEH不太可能推改变治疗方法,这可能导致未经治疗的疾病.
结论:
- 在接受和对待待释放的测试结果时,PEH面临着巨大的挑战.
- 目前的沟通方法不足以有效地达到PEH,可能会导致疾病的治疗不足.
- 医疗保健机构和医疗保健系统必须制定创新的沟通策略,包括与社区资源建立伙伴关系,以改善PEH的护理.
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