住房不稳定性和患者的治疗结果 敏感的外科条件
Emily E Evans1, Nicholas Kunnath2, Esther J Oh2
1University of Michigan Medical School, Ann Arbor, Michigan.
The Journal of surgical research
|December 8, 2024
概括
住房的不稳定性大大增加了意外手术和医院费用的几率. 然而,无家可归或住房不足的患者有类似或更好的外科手术结果.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 外科手术的结果
- 卫生经济学 卫生经济学
背景情况:
- 住房不稳定是已知的健康的社会决定因素,但它对手术患者的影响还没有得到充分研究.
- 敏感的手术条件需要及时干预,使住房稳定性成为最佳护理的关键.
研究的目的:
- 评估住房不稳定性与未计划的外科手术之间的关联.
- 评估住房不稳定对接受接触敏感手术的患者健康和财务结果的影响.
主要方法:
- 使用了医疗保健成本和利用项目国家住院样本 (NIS) 数据库.
- 使用国际疾病分类第10版临床修改 (ICD-10-CM) 住房状况代码 (Z59.0,Z59.1) 进行特定访问敏感的外科手术的确定的患者.
- 采用风险调整的多变量逻辑回归来比较住房稳定和住房不稳定的患者群体之间的结果.
主要成果:
- 住房不稳定的个人经历非计划性手术的几率是四倍以上 (OR4.41,P<0.001).
- 住房不稳定的患者在计划性手术后经历了更长的住院时间和更高的成本.
- 在计划外科手术后的组之间没有观察到患病率或死亡率的显著差异;住房不稳定的患者在计划外科手术后的并发症和死亡率较低.
结论:
- 住房不稳定与意外手术的可能性更高,住院时间增加和成本增加有关.
- 尽管面临挑战,但住房不稳定的患者表现出类似或改善的外科手术结果.
- 扩大负担得起的住房计划可以提高获得及时和有效的外科护理的机会.
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