预测美国印第安人/阿拉斯加原住民末期脏病患者的宿舍使用情况
medRxiv : the preprint server for health sciences
|February 12, 2026
概括
预测模型可以识别影响美国印第安人/阿拉斯加原住民末期脏病患者住院护理的因素,突出需要改善获得息护理的机会,并解决地理差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 美国印第安人/阿拉斯加土著人口经历了不成比例的末期脏疾病 (ESKD) 的高率.
- 治疗ESKD的选择,包括移植和透析,取决于健康的社会决定因素,农村人口由于移植机会有限,往往偏爱透析.
- 这些群体中的患者不太可能接受临终关怀,这可能导致生活质量下降.
研究的目的:
- 开发一个预测模型,估计脏移植接受者之间的宿舍使用概率.
- 确定影响这一群体住院护理使用的关键因素.
主要方法:
- 对2022年USRDS标准分析文件的回顾性分析.
- 使用区域贫困指数 (ADI) 数据,包括社会经济和医疗保健获取变量.
- 采用机器学习技术,包括回归树,随机森林,增强和支持矢量机器来预测临终关怀的使用.
主要成果:
- 随机森林和增强模型在预测临终关怀使用方面表现出卓越的表现.
- 确定的主要预测因素包括IHS地区,年龄和区域贫困指数 (ADI).
- 结果表明共变量和临终关怀使用之间存在非线性关系,机器学习模型可能比传统的物流回归更好地捕捉到这种关系.
结论:
- 结合ADI等措施的预测模型可以揭示医疗保健获取的地理差异.
- 干预措施应针对服务不足的社区,以改善获得临终关怀和息护理的机会.
- 医疗保健系统必须优先考虑所有ESKD患者平等获得息治疗.
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