评估来自贫困人口的澳大利亚儿童医院结果中的不平等现象
Karen Zwi1,2, Jahidur Rahman Khan2, Seaneen Wallace1,2
1Department of Community Child Health, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia.
Hospital pediatrics
|April 16, 2025
概括
来自服务不足的背景的儿童和年轻人面临着严重的健康不平等,住院和再接收的风险更高. 有针对性的干预措施对于解决这些差异和改善所有CYP的健康结果至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 儿科健康结果的结果
- 卫生公平研究 卫生公平研究
背景情况:
- 对于来自各种服务不足的人群的儿童和青少年 (CYP),存在持续的健康结果不平等.
- 量化这些基线不平等对于评估未来公平干预措施的有效性至关重要.
研究的目的:
- 量化基线健康结果不平等性对于服务不足的CYP.
- 建立一个衡量旨在减少健康差异的干预措施影响的基准.
主要方法:
- 来自悉尼儿童医院网络 (2015-2019) 的CYP电子病历分析.
- 主要结局包括高急性呈现,潜在可预防住院 (PPH),慢性病住院,违背医疗建议出院 (DAMA),病房和重症监护入院,再入院和延长住院时间 (LOS).
- 用通用估计方程模型来评估服务不足人口状况和健康结果之间的关系.
主要成果:
- 服务不足的CYP占住院和急诊室遭遇的三分之一.
- 与非低服务人群相比,观察到PPH (RR,1.25) 慢性疾病 (RR,1.09),DAMA (RR,1.33),病房入院 (RR,1.16),再入院 (RR,1.48),延长住院LOS (RR,1.21) 和ED LOS (RR,1.11) 的风险增加.
- 与没有这些风险因素的CYP相比,具有残疾的本地CYP的再录取风险高出239% (RR,3.39).
结论:
- 对于服务不足的CYP,仍然存在重大的健康不平等,需要有针对性的干预措施.
- 拟议的战略包括加强患者识别,改善服务获取和全系统的文化变化.
- 建议在公平学习卫生系统框架内实施,以推动改进.
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