在无家可归者中,创伤后再接收的经验
John F Jachimiak1, Yasmin Arda1, Carly C Amon1
1Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
JAMA surgery
|December 3, 2025
概括
无家可归的人在创伤伤害后的30天住院再入院的风险明显更高. 这凸显了需要更好地规划出院和获得住房和急性后护理服务的需求.
科学领域:
- 创伤外科手术是什么
- 医疗服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 无家可归的人面临着创伤损伤后恢复的重大障碍.
- 对于这一群体的创伤再入院风险的国家估计是有限的.
研究的目的:
- 为了评估无家可归状态和创伤后30天的住院再入院之间的关联.
主要方法:
- 使用2017-2019年国家再接收数据库进行回顾性队列研究.
- 包括因创伤而入院的成年人 (18+),通过ICD-10-CM代码识别.
- 分析了2,663,876例创伤住院病例,其中46,381例 (1.7%) 被确定为无家可归者.
主要成果:
- 没有住所的患者有更高的30天再入院率 (19.3%对12.2%) 和更高的调整几率 (aOR,1.63).
- 再入院往往是因为新的创伤,之前的创伤的后果或术后并发症.
- 违背医疗建议的出院与无住所患者中再入院风险最高 (30.3%) 相关.
结论:
- 无家可归状态独立地与创伤后更高的30天再入院几率有关.
- 干预措施应侧重于改善出院规划,护理连续性以及获得住房和急性后服务.
- 解决结构性障碍对于改善无家可归的创伤患者的结果至关重要.
相关概念视频
Post-traumatic Stress Disorder
448
Post-traumatic stress disorder (PTSD) is a psychiatric condition that arises following exposure to traumatic events such as natural disasters, forced displacement, or severe accidents. It significantly impairs individuals' ability to cope with daily activities and disrupts their emotional and psychological equilibrium.
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
448
Traumatic Memory
519
Emotionally traumatic events often lead to memories that are exceptionally vivid and enduring, sometimes persisting with remarkable clarity throughout an individual's life. A classic example of this phenomenon is a person who survives a car accident. Even years later, they may recall every detail of the event with startling accuracy — the screeching of the tires, the jarring impact, and the acrid smell of burning rubber. Such vividness contrasts sharply with how an individual...
519
Specialized Care Centers and Settings-II
1.2K
Rural Health Centers
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
1.2K
Repressed Memory
463
Repressed memories are a psychological phenomenon where memories of traumatic events are unconsciously blocked from a person's awareness. This process occurs as a defense mechanism, protecting the mind from the emotional impact of distressing or painful experiences. For example, a person who has experienced childhood trauma may grow up with no conscious recollection of the event. In such cases, the memories are thought to be buried deep within the subconscious, inaccessible to the conscious...
463
Restorative Care
2.3K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
2.3K
Dissociative Disorders
436
Dissociative disorders represent complex psychological conditions characterized by disruptions in consciousness, memory, identity, or perception. These disruptions cause individuals to experience a disconnection from their thoughts, emotions, and memories. The phenomenon is not merely an occasional lapse in attention but a profound alteration in mental functioning that can severely impact daily life.
Dissociative Fugue
A hallmark feature of dissociative disorders is the dissociative fugue...
Dissociative Fugue
A hallmark feature of dissociative disorders is the dissociative fugue...
436


