伊利诺伊州社区卫生需求评估:优先考虑枪支暴力的差异
Rolando J Casas Fuentes1, Shelbie D Waddle, Rochelle Dicker
1From the Northwestern Feinberg School of Medicine (R.J.C.F.), Department of Surgery (S.D.W., L.C.T.), Northwestern Feinberg School of Medicine; Department of Trauma (S.D.W., B.T.C.), American College of Surgeons Chicago, Illinois; Department of Surgery (R.D.), University of California San Francisco, San Francisco, California; and Department of Surgery (B.T.C), Connecticut Children's Medical Center, Hartford, Connecticut.
在高枪支死亡率地区的医院更有可能识别暴力预防需求. 然而,很少有人概述干预计划,强调了识别和行动之间的差距.
科学领域:
- 公共卫生
- 医疗服务研究
- 预防伤害
背景情况:
- 在美国,暴力伤害每年造成大量死亡和残疾.
- 医院在多大程度上把预防暴力放在首位,
- 社区卫生需求评估 (CHNA) 是确定社区卫生优先事项的关键工具.
研究的目的:
- 确定高枪支死亡率县的医院是否优先考虑CHNA的暴力预防.
- 评估创伤中心的指定是否影响了这一优先级.
- 识别暴力问题与实施干预措施之间的差距.
主要方法:
- 来自伊利诺伊州27个县的93家医院的CHNA的横截面审查 (2021-2023年).
- 使用疾病预防控制中心数据 (2017-2021) 分析枪支与所有机制的死亡率.
- 基于死亡率四分之一和创伤中心状态的暴力预防优先级比较.
主要成果:
- 55.9%的医院将暴力视为社区问题.
- 枪支死亡率最高的医院更有可能优先考虑暴力 (62.7%对38.5%,p=0.03).
- 与非创伤中心相比,创伤中心的暴力优先级不高.
- 只有48.1%的医院发现暴力,
结论:
- 枪支死亡率较高的医院更有可能将暴力视为社区健康问题.
- 在识别暴力和制定干预计划之间存在很大的差距.
- 需要加强医院暴力干预计划来弥合这一差距.
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