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识别与尿道外科手术同日取消相关的健康社会决定因素
Lynn Leng1, Pablo A Suarez2, Mubarak A Momodu2
1University of California, San Francisco, CA 94143; UC Berkeley-UCSF Joint Medical Program, Berkeley, CA 94704.
Urology
|March 14, 2025
概括
未计划的泌尿外科手术取消与轮椅使用,黑人种族和过去的监禁有关. 拥有初级保健提供者与更少的取消相关,突出了干预目标.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 泌尿器科的非计划性手术日 (DOS) 取消会对患者的治疗结果,医院的工作流程和医疗保健费用产生负面影响.
- 识别导致这些取消的患者特异性因素对于改善获得护理的机会至关重要.
研究的目的:
- 为了确定与非计划性泌尿外科手术取消在安全网医院相关的上游因素.
- 为旨在减少手术接入差异的有针对性的干预提供信息.
主要方法:
- 从2021年1月到2023年6月进行泌尿外科手术的成年患者的回顾性队列研究.
- 分析患者人口统计,健康的社会决定因素,以及来自电子健康记录的临床数据.
- 多变量后勤回归用于识别手术日取消预测因素.
主要成果:
- 在778名患者中,有17.5%的患者经历了DOS取消.
- 轮椅使用 (OR 3.17),黑人种族 (OR 2.62),入狱史 (OR 2.00) 和之前错过的预约 (OR 1.02) 是取消的重要预测因素.
- 指定初级保健提供者与更低的取消可能性相关 (OR 0.58).
结论:
- 患者特异性因素,包括健康的社会决定因素,显著影响非计划性泌尿外科手术取消.
- 调查结果强调需要有针对性的干预措施来改善医疗保健质量和手术准入的公平性.
- 解决运输需求和一致的初级保健参与等因素可以减少取消.
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