在实施通用查后,患者报告的社会需求与出生结果之间的关联
Nigel Madden1, Irene Li Quan, Joe Feinglass
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, the Program in Public Health, and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Obstetrics and gynecology
|May 22, 2025
概括
患者报告的社会需求,如粮食不安全和住房不稳定,与不利的出生结果有关. 对于有医疗补助保险的孕妇来说,这些关联更为强烈,这凸显了对社会护理干预的需要.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 健康社会决定因素 (SDOH) 的普遍查在产前护理中越来越多地得到实施.
- 了解患者报告的社会需求对出生结果的影响对于有针对性的干预至关重要.
- 之前的研究还没有完全阐明这些协会在普遍查计划的背景下.
研究的目的:
- 评估患者报告的社会需求与出生结果之间的关联.
- 评估这些关联是否在有医疗补助保险的孕妇中存在差异.
- 为提高产妇保健的质量提供信息.
主要方法:
- 对20480名怀孕女性进行了回顾性队列研究,对她们的社会需求进行了查.
- 分析患者报告的社会需求 (交通,药品负担能力,粮食不安全,住房不安全,心理健康护理需求).
- 多变量模型控制社会人口统计学和临床因素;对医疗补助受益者的子组分析.
主要成果:
- 4.2%的患者报告至少有一种社会需求.
- 社会需求与严重孕产妇发病率和低出生体重的风险增加有关.
- 在医疗补助受益者中,社会需求与严重的孕产妇发病率和产前症有更大的关联.
结论:
- 患者报告的社会需求与不良出生结果有显著的关联.
- 有医疗补助保险的孕妇经历了放大风险.
- 改善卫生系统质量和社会护理外展对于改善与怀孕相关的健康至关重要.
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