远离家乡:患者的偏好和可接受的风险耐受性对于地方和区域创伤护理
Patrick McGillen1, Eddie Rodriguez2, Shea Gallagher1
1Division of Trauma, Emergency Surgery and Surgical Critical, Los Angeles General Medical Center, 2051 Marengo St, Los Angeles, CA, 90033, USA; Department of Surgery, University of Southern California Keck School of Medicine, 1975 Zonal Ave, Los Angeles, CA, 90033, USA.
American journal of surgery
|June 24, 2025
概括
许多创伤患者优先考虑当地护理,即使它涉及稍高一些风险. 了解患者的偏好是设计有效创伤护理系统的关键.
科学领域:
- 创伤外科 手术 创伤外科
- 医疗保健服务研究 医疗服务研究
- 以患者为中心的护理
背景情况:
- 创伤护理的区域化可以提高患者的治疗结果.
- 然而,集中式系统可能与患者的偏好或风险承受能力不一致.
- 这项研究调查了患者在当地和区域创伤护理之间做出的选择.
研究的目的:
- 分析创伤患者对当地和区域护理的偏好.
- 在创伤治疗地点的背景下评估患者的风险容忍度.
- 确定影响有关创伤护理近距离决策的因素.
主要方法:
- 使用结构化调查和修改的标准博实用性评估.
- 从创伤住院患者收集关于当地护理可接受的额外手术风险的数据.
- 采用后勤和混合模型回归来确定风险接受的预测因素.
主要成果:
- 显著多数 (88-89%) 喜欢当地的护理,当风险与区域中心相等时.
- 即使风险增加了2%,28-36%的人仍然倾向于接受局部治疗.
- 患有形伤害的患者更倾向于接受局部护理,平均接受3%的额外风险.
结论:
- 患者的偏好和风险承受能力是创伤系统设计的关键因素.
- 许多患者选择当地的创伤护理,尽管潜在的风险增加.
- 纳入以患者为中心的选择可以优化创伤护理的提供.
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