对严重受伤的老年人创伤中心利用的系统级变量
Alexander J Ordoobadi1, Manuel Castillo-Angeles2, Masami Tabata-Kelly3
1Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts; The Gillian Reny Stepping Strong Center for Trauma Innovation, Boston, Massachusetts.
The Journal of surgical research
|December 1, 2024
概括
严重受伤的老年人没有得到足够的检查. 有更多创伤中心 (TC) 的地区为这些患者提供更高的运输费用,这表明TC可以改善获得创伤护理的机会.
科学领域:
- 创伤外科手术和急诊医学
- 老年创伤护理老年创伤护理
- 医疗服务研究 医疗服务研究
背景情况:
- 严重受伤的老年人不到创伤中心 (TC) 是一个重大问题.
- 系统层面的因素,特别是TC的区域供应,是人们不太了解的不足选的因素.
- 本研究调查了TC供应与严重受伤的老年人被运送到TC的可能性之间的关系.
研究的目的:
- 为了确定一个地区更多的创伤中心 (TC) 供应是否与严重受伤的老年人运输率更高有关.
- 检查影响老年创伤患者低治的系统级因素.
主要方法:
- 使用医疗保险数据 (2014-2015年) 的回顾性横截面研究.
- 分析了居住在城市/郊区创伤服务区 (TSA) 的严重受伤 (受伤严重程度评分>15) 的老年人 (≥65岁).
- 使用多变量等级后勤回归来评估TC供应 (人均三角动物) 和TC运输之间的关联,控制患者和伤害特征.
主要成果:
- 包括309个TSA中68128名严重受伤的老年人.
- 具有最高TC供应 (4.15TC/百万) 的TSA有68.5%的患者被运送到TC,而具有最低供应 (1.13TC/百万) 的TSA的患者为38.8%.
- 较高的TC供应与TC运输的可能性增加显著相关 (OR4.23;P<0.001).
结论:
- 更大的区域创伤中心 (TC) 供应与严重受伤的老年人的TC运输率更高有关.
- 在创伤服务区域内优化TC分布可能是减轻这一脆弱人群中不足的策略.
- 确保足够的TC可用性对于改善老年人获得专门创伤护理的机会至关重要.
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