美国成年人的社会风险因素领域和预防性护理服务
Tamara Schroeder1, Mukoso N Ozieh2,3,4, Abigail Thorgerson3
1Department of Surgery, University of California, Davis, Sacramento.
JAMA network open
|October 4, 2024
概括
健康的社会决定因素,如教育缺陷和缺乏获得护理的机会,与使用基本预防服务的减少有关. 解决这些社会风险对于改善医疗保健获取和结果至关重要.
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
- 社会流行病学 社会流行病学
背景情况:
- 越来越多的证据表明,健康的社会决定因素 (SDOH) 对预防性护理的采用有负面影响.
- 了解SDOH领域与各种预防服务之间的特定关联对于有针对性的干预至关重要.
研究的目的:
- 调查不同社会风险因素领域之间的独立关联以及美国成年人使用关键预防护理服务.
- 量化多种社会风险因素对获得预防服务的累积影响.
主要方法:
- 对超过8.2万个人的国家健康访谈调查数据 (2016-2018) 的横截面分析.
- 检查了六个社会风险领域 (经济不稳定,社区缺乏,教育赤字,粮食不安全,社会隔离,获得护理) 和五个预防性服务之间的关联:乳房检查,帕帕尼科劳检查,结肠镜检查,流感疫苗和肺炎球菌疫苗.
- 对人口统计因素,保险状况和并发症进行控制的物流回归模型.
主要成果:
- 教育缺陷和缺乏护理的机会与接受分析的所有五种预防性服务的几率较低显著相关.
- 观察到一个累积效应:每一个额外的社会风险因子领域都与接受乳房镜检查,帕帕尼科劳检查,流感疫苗,肺炎球菌疫苗和结肠镜检查的几率降低有关.
- 具体的几率比率 (ORs) 表明预防性服务使用量大幅减少,社会风险负担增加 (例如,乳房检查的OR与社会风险增加计数为0.74).
结论:
- 社会风险因素领域独立和累积地与美国基本预防护理服务的减少有关.
- 旨在缓解健康的社会决定因素的干预措施是必要的,以改善遵守推的预防性查和疫苗接种.
- 解决社会风险是优化预防性护理提供和减少健康差距的重要组成部分.
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