无法获得初级保健和可避免的急诊室访问的无证患者:来自安全网系统的证据
Journal of health care for the poor and underserved
|August 18, 2025
概括
在洛杉矶的无证患者.
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
- 健康 公平 卫生 公平
背景情况:
- 无证移民在获得医疗保健方面面临重大障碍.
- 安全网计划旨在减轻弱势群体面临的这些障碍.
- 了解医疗保健利用模式对于计划评估至关重要.
研究的目的:
- 为了比较我的健康LA (MHLA) 计划中无证患者之间的可避免的急诊室 (ED) 访问率与其他外国出生的患者群体.
- 评估特定医疗保健覆盖计划对ED利用在门诊护理敏感条件的影响.
主要方法:
- 来自洛杉矶县安全网医院的2016-2020年ED遭遇的分析.
- 三组患者的比较:MHLA无证患者,非MHLA无证患者和外国出生的有证据的患者 (n=567,671).
- 混合效应模型用于估计 ambulatory care敏感条件的可避免ED访问的几率.
主要成果:
- 与记录和非MHLA未记录患者相比,MHLA患者对急性疾病和非糖尿病慢性疾病的可避免ED访问的可能性较低.
- 在MHLA患者中,与2型糖尿病 (T2D) 相关的ED访问的可能性更高.
- 通过MHLA获得定期的初级保健改善了某些条件的利用率,但强调了正在进行的T2D管理挑战.
结论:
- "我的健康LA"计划似乎有效地减少了一些可以避免的急救诊所对无证人口的访问.
- 针对性干预可能需要在计划参与者中管理慢性疾病,如2型糖尿病.
- 获得医疗保健可以改善急性和慢性疾病的管理,但并不能完全解决所有健康差异.
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