在肺癌查队列中测量与健康相关的社会风险
Farouk Dako1, Pavel Karasek2, James Seward3
1Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Director, Center for Global and Population Health Research in Radiology.
Journal of the American College of Radiology : JACR
|April 21, 2025
概括
在肺癌查 (LCS) 患者中评估与健康相关的社会风险 (HRSR) 是可行的,但具有挑战性. 结合电子健康记录,社区数据和采访,尽管数据有限,但提供了全面的视图.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 与健康相关的社会风险 (HRSRs) 显著影响患者的治疗结果和遵守医疗指南.
- 肺癌查 (LCS) 计划为不同社会需求的不同人群提供服务.
- 了解HRSR对于公平有效的LCS交付至关重要.
研究的目的:
- 评估在肺癌查队列中测量HRSR的可行性和局限性.
- 探索多个数据源,以捕捉个人和社区层面的社会风险.
- 识别受社会因素影响的LCS坚持障碍和促进者的障碍.
主要方法:
- 一项单一机构的研究分析了实用性LCS试验中的227名参与者的数据.
- 通过电子健康记录 (EHR),社区社会经济地位 (修改的Yost指数) 和半结构面试来评估HRSR.
- 与15名参与者的采访探讨了LCS遵守的障碍和促进者.
主要成果:
- 电子健康数据发现了财务压力和住房不稳定,但缺失率很高 (64-69%).
- 与更广泛的社区相比,邻里分析表明LCS群体的社会经济地位较低.
- 采访显示LCS知识有限,依赖公共交通,对提供商的信任;运输不是主要障碍.
结论:
- 在LCS队列中测量HRSR是有希望的,但在EHR中面临数据限制.
- 患者采访提供了丰富的个人体验,而邻里分析提供了上下文社会经济见解.
- 综合,多源数据收集对于全面了解患者群体中HRSRs至关重要.
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