了解无家可归者寻求医疗护理的模式:对急诊室使用量的定量多中心分析
Abdi Osman1,2, Jahar Bhowmik3, Jerome Rachele4
1Institute of Health and Sports, College of Sports, Health and Engineering, Victoria University, Melbourne, Australia. abdi.osman@vu.edu.au.
无家可归的人 (PEH) 需要量身定制的医疗保健. 这项研究发现,PEH存在复杂的需求,不同结果受分拣敏度的影响,突出了急诊室 (ED) 灵活护理途径的需要.
科学领域:
- 公共卫生 公共卫生
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 无家可归者 (PEH) 在获得医疗保健服务方面面临重大障碍.
- 紧急部门 (ED) 是PEH的关键联系点,但他们的复杂需求并不总是得到充分满足.
- 了解PEH在ED患者的特征和寻求医疗保健的行为对于改善护理至关重要.
研究的目的:
- 探索PEH在澳大利亚大都市EDs的社会人口和临床特征.
- 调查该人口的健康寻求行为和护理寻求模式.
- 确定与处置状态相关的因素,并为响应性护理途径的发展提供信息.
主要方法:
- 采用了定量观测研究设计.
- 分析了2023年PEH呈现的ED记录中的行政和临床数据.
- 使用SPSS (v30) 和R (4.5.1) 进行了统计分析.
主要成果:
- 分析了310例PEH病例的队列,平均年龄为42.4岁,平均ED停留时间为8.48小时.
- 处置状态与分拣敏度,自我伤害史,物质使用,慢性疾病,自杀意图和紧急精神病学审查有显著的关联.
- 患有自我伤害或药物使用史的患者更有可能安排后续检查 (分别p < 0.001和p = 0.006),年轻患者更常被转诊到精神卫生机构 (p = 0.002).
结论:
- 患有各种心理社会和临床需求的PEH,包括高自伤率,精神健康状况,物质使用和慢性疾病.
- 处置结果有显著的差异,非紧急分拣与违背医疗建议离开的更高率有关.
- 灵活和响应性护理途径对于解决PEH向EDs提出的医疗保健需求的异质性和复杂性至关重要.
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