社区建筑环境和家庭透析利用:城市依赖的模式和政策影响的不同模式
Byoungjun Kim1, Yiting Li2, Myeonggyun Lee3
1Department of Surgery, New York University Grossman School of Medicine, New York, New York; Department of Population Health, New York University Grossman School of Medicine, New York, New York.
概括
建筑环境对家庭透析使用的影响因地点而异. 城市地区在医疗服务不足和拥挤的地区看到的家庭透析较少,而农村地区在设施距离增加的情况下看到更多.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 公共卫生 公共卫生
- 城市规划 城市规划
背景情况:
- 家庭透析 (腹膜透析或家庭血液透析) 的普及率仍然很低,尽管有国家倡议.
- 建筑环境的特点可能会影响家庭透析利用率.
研究的目的:
- 检查建筑环境因素与家庭透析启动之间的关联.
- 调查这些关联如何因城市而异.
主要方法:
- 在2010年至2019年期间,对1,103,695名开始透析的成年人进行了回顾性队列研究.
- 检查了医疗服务不足的地区 (MUAs),透析设施的距离,以及邮政编码层面的住房特征 (过度拥挤,结构).
- 使用多层次的物流回归,按城市化分层 (城市,郊区,小镇,农村).
主要成果:
- 医疗服务不足的地区和住房过度拥挤与城市和郊区环境中的家庭透析使用减少有关.
- 到透析设施的距离增加与小城镇和农村地区更高的家庭透析使用有关.
- 这些协会强调建筑环境基于地理位置的差异性影响.
结论:
- 建筑环境的特点显著影响家庭透析的吸收,影响因城市而异.
- 应针对家庭透析障碍的政策应根据特定的城市级别量身定制.
- 策略包括优化城市/郊区的透析剂输送,并促进远离农村地区设施的家庭透析.
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