初级护理和急诊室访问:弗吉尼亚全祷声索赔数据库
Michael Topmiller1, Hannah Shadowen2, Mark A Carrozza2
1From The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MT); Department of Health Policy, Virginia Commonwealth University, Richmond, VA (HS); The Robert Graham Center, American Academy of Family Physicians (AAFP), Washington, DC (MAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (JBB); Department of Biostatistics, Virginia Commonwealth University, Richmond, VA (RTS); Department of Epidemiology, Virginia Commonwealth University, Richmond, VA (DAC); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (SMS); Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA (AHK). mtopmiller@aafp.org.
较高的初级保健利用率与弗吉尼亚州较低的急诊室 (ER) 使用率有关. 地理分析显示,在全州的初级保健和急救诊所访问率中,存在不同的模式.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 地理健康分析 地理健康分析
背景情况:
- 研究了初级保健利用率与急诊室 (ER) 使用率之间的关系.
- 通过使用全付款人索赔数据库 (APCD) 检查了弗吉尼亚州初级保健和急救利用的地理差异.
研究的目的:
- 为了确定初级保健使用率与急诊室 (ER) 使用率之间的关联.
- 探索弗吉尼亚州的初级保健和急救利用的地理模式.
主要方法:
- 弗吉尼亚州全付款人索赔数据库 (APCD) 的回顾性观察分析.
- 采用贝叶斯平滑技术,回归分析和地理信息系统 (GIS) 地图.
- 分析涵盖了弗吉尼亚州的866个邮政编码表格区 (ZCTA).
主要成果:
- 发现了显著的反向关系:每1000人初级保健率增加10次,每1000人急诊率减少7次.
- 地理信息系统绘制的地图确定了弗吉尼亚州中部和东部地区的高初级保健利用率集群,弗吉尼亚州南部的比例较低.
- 西弗吉尼亚州的ER使用率较高,弗吉尼亚州北部的使用率较低.
结论:
- 初级保健利用率与急诊室使用率的减少有关,得到了APCD数据和GIS映射的支持.
- 在弗吉尼亚州,初级保健和急救利用的不同地理模式是显而易见的.
- 未来的研究应该确定优先领域,分析它们的特点,并进行定性研究,以了解影响这些利用率的当地因素.
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