儿童脑损伤后的长度医疗保健使用:基于人口的出生队列研究
Vincy Chan1,2,3,4, Clarissa Serafine Wirianto1, Robert Balogh2
1KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Canada.
PloS one
|February 24, 2025
概括
患有创伤性脑损伤 (TBI) 的儿童在访问后的10年内使用医疗保健的比例较高,因收入和农村地区等社会决定因素而异. 了解这些长期影响对于有针对性的干预至关重要.
科学领域:
- 儿科创伤学 儿科创伤学
- 公共卫生研究 公共卫生研究
- 医疗保健服务研究 医疗保健服务研究
背景情况:
- 儿童的创伤性脑损伤 (TBI) 有终身后果,影响发展和长期健康.
- 有限的纵向数据存在于儿童后TBI的医疗保健利用率和健康的社会决定因素的影响.
- 这项研究调查了儿童TBI相关医疗保健访问后长达10年的医疗保健使用模式.
研究的目的:
- 为了分析儿童创伤性脑损伤 (TBI) 诊断后的纵向医疗保健利用率.
- 检查健康的社会决定因素 (SDOH) 如何影响TBI后的医疗保健使用轨迹.
- 为儿童TBI幸存者开发有针对性的健康和社会护理干预措施提供见解.
主要方法:
- 利用来自加拿大安大略省 (2002-2020) 的基于人口的出生队列.
- 对一个TBI队列 (n=26,988) 和一个对照组 (n=193,253) 的医疗保健访问 (初级保健,急诊室,住院) 的比较.
- 计算了10年TBI访问前后指数的医疗保健使用率,按SDOH分层 (农村地区,收入,种族化人口).
主要成果:
- 在指数访问之前和之后,TBI队列始终表现出比对照组更高的医疗保健使用率.
- 医疗保健利用在健康的社会决定因素之间有很大的差异,不同的医疗保健环境有不同的模式.
- 在男性中观察到更高的比例,城市人口的初级保健,农村人口的急诊,ED/住院治疗的低收入五分位数,以及初级保健与ED/住院治疗的特定种族化/新移民人口密度.
结论:
- 持续更高的医疗保健使用童年后的TBI需要进一步研究潜在原因.
- 研究结果强调了在治疗儿科TBI时考虑健康的社会决定因素的重要性.
- 终身视角对于了解早期TBI对健康结果的长期影响至关重要.
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