在COVID-19浪潮之间改善医院息护理:一项回顾性队列研究
Claude Chidiac1, Luigi Sedda2, Catherine Walshe3
1Department of Palliative Care (C.C, M.F., D.F., A.R.), Homerton Healthcare NHS Foundation Trust, London, UK; International Observatory on End-of-Life Care, Division of Health Research, Lancaster University (C.C., C.W., N.P.), Lancaster, LA1 4YG, UK.
Journal of pain and symptom management
|September 19, 2024
概括
在COVID-19大流行期间,息护理转诊的种族差异缩小了. 引入新的治疗方法和服务变化影响了转诊时间,但在第二波疫情中提高了公平性.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 在急症医院的专家息护理服务在COVID-19流行病的第一波期间适应.
- 对于少数族裔群体来说,已注意到推迟转诊.
- 第二波出现了COVID-19治疗方法的引入,如德克萨和抗凝剂,以及服务修改.
研究的目的:
- 分析COVID-19期间息护理模式和趋势的变化,考虑新的治疗方法.
- 评估第一波和第二波流行病之间的息护理转诊的种族差异.
主要方法:
- 一项回顾性队列研究比较了COVID-19患者在第一 (W1) 和第二 (W2) 波期间被转移到息治疗的患者.
- 统计分析包括推时间和生存分析的通用线性混合模型.
- 分析了人口统计,临床和结果数据.
主要成果:
- 在W1中转介发生的时间早于W2. 德克萨米他/抗凝剂等治疗以及痴呆症/高血压等疾病与更长的转诊时间有关.
- 在W1中观察到的推延迟的种族差异在W2中没有出现.
- 社会经济地位与照顾模式没有相关性. 绩效状况和疾病阶段预测的生存率.
结论:
- 这些发现可以指导策略,以提高息护理的响应性和公平性.
- 这项研究为未来的流行病和健康危机提供了见解.
- 第二波观察到,缓和护理获得的公平性得到了改善.
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