负责的护理组织,儿童机会指数和儿童复杂尾炎
Shruthi Srinivas1, Brenna Rachwal1, Kristine L Griffin1
1Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio.
低儿童机会指数 (COI) 与儿童复杂尾炎 (CA) 有关. 负责护理组织 (ACO) 的招生并没有改变这一关联,这表明需要更广泛的社会决定因素干预.
科学领域:
- 儿科手术 儿科手术
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 儿童机会指数 (COI) 与儿科患者的复杂尾炎 (CA) 有关.
- 负责任的护理组织 (ACO) 旨在提高护理价值,可能影响健康结果差异.
- 在儿童中,ACO招生对COI-CA协会的影响需要进行调查.
研究的目的:
- 为了确定在儿童合作伙伴 (PFK) ACO的入学是否会改变儿童中COI和CA之间的关联.
- 分析由COI表示的社会经济因素与复杂尾炎的发病率之间的关系.
- 评估基于价值的护理模式在缓解与尾炎结局相关的健康差异方面的作用.
主要方法:
- 对1337名接受尾切除的公共保险儿童进行了回顾性审查.
- 简单和复杂尾炎病例之间的COI和临床混因子的比较.
- 多变量逻辑回归模型被用来测试COI和PFK招生之间的相互作用.
主要成果:
- 较低的COI五分位数与CA的百分比增加显著相关 (P=0.01).
- PFK的招生并没有改变COI和CA之间的关联.
- 年轻的年龄和非常低的COI独立地与CA相关.
- 与其他公共保险相比,PFK入学与30天的再入学率较少有关.
结论:
- 低社会经济机会与儿童复杂尾炎之间的关联不会因ACO入学而改变.
- 单独的ACO可能不足以解决影响儿科尾炎结果的健康社会决定因素.
- 需要进一步的战略来减轻社会决定因素对儿科外科护理健康差异的影响.
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