美国卫生系统中社会风险与糖尿病指标之间的关系
Jessica L Sosso1, Karen M Fischer2, Michelle A Lampman2
1From the Department of Family Medicine, Mayo Clinic Health System, Sparta, WI (JLS); Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN (KMF); Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN (MAL); Department of Family Medicine, Mayo Clinic, Rochester, MN (GMG, MEB, SVA, TDT); Department of Family Medicine, Mayo Clinic Health System, La Crosse, WI (SKS); Department of Family Medicine, Mayo Clinic Health System, Lake City, MN (RMF); Department of Family Medicine, Mayo Clinic Health System, Owatonna, MN (DAJ). sosso.jessica@mayo.edu).
住房,金融,粮食不安全和交通等社会风险显著影响糖尿病护理质量. 解决这些健康的社会决定因素对于改善初级保健机构患者的治疗结果至关重要.
科学领域:
- 初级保健研究初级保健研究
- 医疗服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 糖尿病护理中的质量指标对于患者健康至关重要.
- 社会风险因素越来越被认为是实现健康目标的重大障碍.
研究的目的:
- 评估多个社会风险领域与2型糖尿病患者综合质量指标之间的关联.
- 在美国一个大型地区实践中,确定影响糖尿病护理质量的特定社会风险.
主要方法:
- 从电子健康记录中对44,010名成年2型糖尿病患者进行横截面分析.
- 定义了一个复合的糖尿病指标 (D5),包括HbA1c,血压,他类药物的使用,避免吸烟和使用阿司匹林.
- 使用多重物流回归来评估社会风险领域 (住房,金融,食品,交通) 控制人口统计.
主要成果:
- 住房,金融,粮食不安全和交通等高风险社会因素的患者不太可能满足D5质量指标.
- 年轻,非白人,农村患者,以及访问利用率较低或某些保险类型较低的患者也不太可能达到指标.
- 证明了社会风险领域与糖尿病质量指标的实现之间存在显著的关联.
结论:
- 社会风险因素对患有糖尿病的初级保健患者有很大的临床影响.
- 强调需要针对健康的社会决定因素进行干预,以改善糖尿病护理.
- 强调将社会风险查和管理纳入常规初级保健的重要性.
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