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为什么潜在的选择性整体外科成为新兴的原因:多方法方法

Denise M Garofalo1, Quintin W O Myers2, Charlotte H Heron1

  • 1School of Medicine, University of Colorado, Aurora, Colorado; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

The Journal of surgical research
|July 18, 2025
PubMed
概括

许多需要选择性手术的患者因延迟护理而最终进入紧急普通手术 (EGS). 健康的社会决定因素 (SDoH) 和访问障碍阻止了及时的选择性程序,增加了患者的风险.

关键词:
紧急的一般外科手术.获得医疗保健的机会.医疗保健中的差异健康的社会决定因素医疗外科的股权.

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科学领域:

  • 一般外科 整体外科
  • 医疗保健服务研究 医疗服务研究
  • 公共卫生 公共卫生

背景情况:

  • 紧急普通手术 (EGS) 与选择性手术相比,与更高的发病率和死亡率有关.
  • 健康的社会决定因素 (SDoH) 显著阻碍了医疗保健的获取,有助于增加EGS利用率.
  • 许多新出现的疾病可以通过更早的干预选择性地管理.

研究的目的:

  • 调查潜在的选择性外科条件的患者为什么接受EGS的原因.
  • 找出阻碍患者及时获得选择性外科护理的障碍.

主要方法:

  • 对995名在学术中心接受EGS的成年患者进行回顾性评估 (2018-2019).
  • 分析患者的人口统计,临床过程和围绕手术时间的情况.
  • 多方法方法来确定选修管理中的失败,包括统计比较.

主要成果:

  • 只有10.5%的确诊患者 (104/995) 被初级保健评估,更少的人被转诊或通过整体外科评估.
  • 不接受选择性手术的主要原因包括并发症优化 (42%),安排困难 (28%),SDoH (22%),错过诊断 (14%) 和患者偏好 (11%).
  • SDoH的障碍包括财务,儿童保育,交通和就业问题.

结论:

  • 在该机构接受EGS治疗的绝大多数患者在入院前没有看过医生.
  • 即使获得初级保健服务,预约接受选择性手术的可能性仍然很低 (约20%).
  • 改善预防护理的准入和简化从诊断到选择性手术的途径对于减少EGS使用至关重要.