使用急性疼痛服务作为对创伤和住院患者管理不平等的镜头
Maxwell B Baker1,2, Rachel Achu-Lopes1, Haley Mullins1
1Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA.
Healthcare (Basel, Switzerland)
|December 11, 2025
概括
在安全网医院使用急性疼痛服务 (APS) 显示出差异,像种族少数群体和那些有物质使用障碍的人这样的弱势群体更有可能获得护理. 创伤患者,特别是年轻的黑人男性,也显示出APS参与度增加,表明护理缺口.
科学领域:
- 疼痛管理 疼痛管理
- 健康 公平 卫生 公平
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性疼痛和门诊诊所的疼痛管理方面的不平等情况得到了记录,但在住院急性疼痛服务 (APS) 护理方面的差异不太了解.
- 本研究研究了影响APS利用和城市安全网医院的结果的人口,临床和社会因素.
- 一个子组分析的重点是多重肋骨骨折的创伤患者及其APS咨询状态.
研究的目的:
- 评估与急性疼痛服务 (APS) 使用和城市安全网医院的患者结果相关的因素.
- 确定APS咨询的人口,临床和社会预测因素.
- 分析APS护理的差异,特别是在脆弱的患者群体和创伤患者中.
主要方法:
- 从2020年1月到2022年11月,对1445名APS咨询和650名肋骨骨折患者进行了回顾性队列研究.
- 分析包括人口统计,保险状况,并发症,阿片类药物处方和出院结果.
- 统计方法包括描述性统计,多变量逻辑回归和逻辑线性模型来识别重要的预测因素.
主要成果:
- 接受APS护理的患者不成比例地来自弱势群体:30.5%的黑人,81.0%的公共保险,32.9%的物质使用障碍 (SUD).
- 甲使用预测非家庭出院. 在肋骨骨折患者中,APS咨询与较高的损伤严重程度相关.
- 黑人患者接受APS咨询的可能性较低,这与年龄较小和男性占主导地位有关,这是咨询的预测因素.
结论:
- 安全网医院的APS利用反映了医疗脆弱性和结构性不平等的交集.
- 弱势群体,包括种族/族裔少数群体,公共保险,以及那些有SUD的人,显示出更大的APS参与.
- 调查结果强调需要标准化APS标准,并整合社会支持和成药物资源,以解决护理差距.
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