患有类风湿性关节炎的人在门诊护理敏感条件下访问急诊室:基于人口的研究
Dani G Contreras1,2, Zanir Bhanji3, J Antonio Aviña-Zubieta2,4
1McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.
PloS one
|December 10, 2025
概括
与一般人群相比,患有类风湿性关节炎 (RA) 的人因出院护理敏感疾病 (ACSC) 而有30%的可避免的急诊室 (ED) 访问率高于一般人群. 改善获得初级和专科护理的机会可以减少ED负担.
科学领域:
- 类风湿病学 类风湿病学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性炎症疾病,影响关节健康和整体健康.
- 门诊护理敏感条件 (ACSCs) 是一种条件,适当的门诊护理可以防止住院或急诊室访问.
- 了解RA患者中ACSCs的ED利用模式对于优化医疗保健提供至关重要.
研究的目的:
- 与匹配的对照人群相比,估计患有类风湿性关节炎 (RA) 的人群的门诊护理敏感条件 (ACSC) 的急诊室 (ED) 访问率.
- 量化RA患者与普通人群之间的ACSCEDEDED访问率的差异.
- 随着时间的推移,确定RA患者中ACSC的ED访问趋势.
主要方法:
- 利用基于国际疾病分类 (2002-2023) 代码的验证定义来识别RA病例和ACSC诊断.
- 分析了来自国家门诊护理报告系统 (NACRS) 的数据,以提取 ACSC 的 ED 访问敏度.
- 采用多变量回归模型来估计发病率比率,调整年龄,性别,居住地和社会经济地位.
主要成果:
- 与非RA对照组 (n=94,094) 相比,患有RA的个人 (n=35,770) 在所有ACSC组合中表现出更高的ED访问率,调整后的发病率比率为1.30.
- 超过三分之二的急救诊所访问RA患者的ACSCs被分类为"紧急"或更严重.
- 在研究期间,在RA患者中观察到ACSC的ED访问比例增加了34%.
结论:
- 与非RA患者相比,RA患者在诊断后五年内经历了ACSCs可避免的ED访问率高出30%.
- 建议加强门诊护理的准入和质量,包括初级和亚专科服务,以减轻急性护理的负担.
- 这些发现强调了需要主动管理慢性疾病如RA,以减少可预防的ED使用率.
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