与退伍军人相关的因素 社区与VA紧急部门的使用
Anita A Vashi1,2,3, Steven M Asch1,4, Tracy Urech1
1Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California.
退伍军人更有可能使用社区急诊室 (EDs) 由于距离,先前的社区护理和高急性条件. 需要有针对性的战略,以确保所有退伍军人获得公平的紧急护理.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 退伍军人卫生管理局退伍军人卫生管理局
- 紧急医疗 紧急医疗
背景情况:
- 美国退伍军人事务部 (VA) 致力于为退伍军人提供全面的紧急护理服务.
- 了解影响退伍军人在VA和社区急救部门 (ED) 之间的选择因素对于优化护理提供至关重要.
- 目前关于退伍军人社区ED利用的驱动因素的知识有限.
研究的目的:
- 确定和分析与寻求社区设施紧急护理的退伍军人与VA设施相关的关键因素.
- 为旨在改善退伍军人人口紧急护理获取和协调的政策和实践提供信息.
主要方法:
- 一项回顾性横截面研究分析了2021年10月至2022年9月期间超过130万退伍军人紧急诊所访问的数据.
- 这项研究包括18岁及以上的退伍军人,他们至少一次访问了美国和波多黎各的退伍军人或社区急救中心.
- 使用后勤回归模型来确定各种患者,临床和地理因素之间的关联,以及社区ED与VAED的选择.
主要成果:
- 社区ED使用与设施距离更远,以前社区ED使用和更高的敏度诊断有显著的关联.
- 相反,以前的VAED访问和初级保健使用与社区ED使用的可能性下降相关.
- 与白人退伍军人相比,种族和少数民族退伍军人的社区ED使用率始终较低.
结论:
- 退伍军人紧急护理场所的选择受到了地理可达性,既定的护理模式和病情的严重程度的影响.
- 在不同的种族和民族群体中,社区ED使用的差异存在.
- 制定有针对性的干预措施对于加强护理协调和保证所有退伍军人获得公平的紧急护理至关重要.
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