邻里机会,医院数量和儿科术后死亡率
Sandra Tay1, Christian Mpody2, Joseph D Tobias1,3
1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
JAMA network open
|November 12, 2025
概括
来自贫困社区的孩子面临着更高的医院术后死亡风险. 解决社区机会对于改善儿科手术结果至关重要,因为仅靠医院的数量无法缓解这些差异.
科学领域:
- 儿科手术 儿科手术
- 健康差异 在健康上的差异
- 健康的社会决定因素
背景情况:
- 社会人口统计学因素影响儿科外科护理,经常把弱势群体集中在体积较小的医院里.
- 邻里条件对儿童健康至关重要,但它们对术后死亡率及其医院容量的影响还不清楚.
研究的目的:
- 检查邻里机会和儿科术后死亡率之间的关联.
- 为了确定医院的数量是否改变了邻里机会和死亡率之间的关系.
主要方法:
- 使用儿科健康信息系统 (PHIS) 数据库 (2012-2024) 的回顾性队列研究.
- 包括18岁以下儿童的住院外科治疗.
- 通过儿童机会指数3.0来衡量社区机会;医院数量被分类为高或低.
主要成果:
- 更高的邻里机会与较低的住院术后死亡风险有关.
- 非常低机会社区的儿童与非常高机会地区的儿童相比,死亡风险高出27%.
- 低人数中心的护理与11%更高的死亡风险有关,但医院的数量并没有改变邻里机会-死亡率的关联.
结论:
- 邻居机会是儿科术后死亡率的一个重要因素.
- 来自弱势社区的儿童手术结果的差异仍然存在,即使是在大量的中心.
- 解决区域一级的健康社会决定因素对于改善儿科外科护理公平性至关重要.
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