社会经济弱势群体可能未充分利用紧急部门对不可避免的访问, 2018-22
Richard K Leuchter1, Melody Craff2, Sitaram Vangala3
1Richard K. Leuchter (rleuchter@mednet.ucla.edu), University of California Los Angeles and Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California.
Health affairs (Project Hope)
|March 3, 2025
概括
由于COVID-19大流行,所有人都减少了可能可以避免的急诊室 (ED) 访问,但弱势群体现在可能对严重疾病的ED使用不足,这表明有新的医疗保健准入差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 在COVID-19大流行之前,在社会经济弱势群体中,急救部门 (ED) 的使用速度更快.
- 办公室护理的障碍导致弱势群体中ED使用率增加.
- 疫情对使用ED的社会经济差异的长期影响尚不清楚.
研究的目的:
- 调查COVID-19大流行对急诊室 (ED) 使用社会经济差异的持久影响.
- 为了比较流行病期间 (2020年3月至2022年8月) 的ED访问率与流行病前 (2018-19年) 的比率.
主要方法:
- 以回顾的队列研究,利用美国的多重付款索赔数据.
- 差异分析分析,比较流行病和流行病前期间的ED访问率.
- 按保险类型分层 (商业,医疗保险,医疗补助,双重资格) 来评估社会经济差异.
主要成果:
- 在疫情期间,所有保险人群的潜在可避免的急救访问减少了.
- 潜在的不可避免的ED访问最初下降,但在商业保险和医疗保险患者中基本恢复到大流行前的水平.
- 潜在的不可避免的急救诊所访问仅回归到医疗补助和双重资格患者预期率的约75%.
- 一个差异出现了,社会经济上处于不利地位的群体可能会在更高的急性条件下使用ED.
结论:
- 疫情减少了可能可以避免的ED使用,但可能加剧了获得必要护理的差异.
- 在社会经济上处于不利地位的人群中,特别是那些有医疗补助或双重资格的人群,在潜在的不可避免的访问中,ED服务的使用不足.
- 调查结果表明,需要解决弱势群体获得护理的根本障碍,以防止急性疾病的紧急服务使用不足.
更多相关视频
06:52Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
9.6K
04:05Author Spotlight: Unveiling Prognostic Indicators in Heart Failure - The Role of Phase Angle and Bioelectrical Impedance Analysis
Published on: June 30, 2023
1.7K
相关概念视频
01:29Issues And Trends In Healthcare Delivery System
5.6K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
5.6K
01:30Preventive Healthcare Services
957
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
957
01:26Methods Of Healthcare Delivery System
3.1K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.1K
01:18Introduction To Health Care Delivery System
2.6K
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
2.6K
01:11Secondary Healthcare System
1.4K
Secondary healthcare is offered by a specialist, generally in hospitals or clinics for patients referred by primary healthcare providers. It occurs when a person has an illness or injury that requires specific medical care. Secondary care is often referred to as acute care. Secondary care can range from uncomplicated care to repair a minor laceration or treat a strep throat infection to more complicated emergent care, such as treating a head injury sustained in an automobile accident. Whatever...
1.4K
01:30Primary Healthcare Services
1.3K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.3K