患者邻居预测的抗性预防护理过程中的差异:回顾性队列和地理空间分析
Jiuying Han1, Neng Wan1, Cameron K Jacobson2
1School of Environment, Society and Sustainability, University of Utah, 260 South Central Campus Drive, Room 4625, Salt Lake City, UT, 84112, United States, 1 801-646-5989.
JMIR public health and surveillance
|February 24, 2026
概括
在弱势社区中确定了治疗不足的反性预防的地理集群. 这些地区的患者接受的抗药较少,突出显示了术后护理的差异.
科学领域:
- 医疗保健差异研究 医疗保健差异研究
- 公共卫生中的地理空间分析
- 在外科手术期间的医学.
背景情况:
- 健康的社会决定因素显著影响术后护理,导致持续的差异.
- 之前的研究发现了在外科手术期间的过程中存在种族和社会经济差异,包括服用抗emetic预防药物.
- 美国的社区隔离需要检查这些差异的地理空间聚类.
研究的目的:
- 为了确定外科手术期间的反吐性预防差异是否表现出基于邻居劣势的地理聚类.
- 评估来自弱势群体的患者是否更有可能在术后恶心和吐方面接受治疗不足,并根据个人风险进行调整.
- 为了研究在外科手术期间治疗中抗emetic治疗不足的空间模式.
主要方法:
- 来自犹他大学医院的19477个麻醉记录的回顾性队列研究.
- 患者地址的地理编码与人口普查区组级邻里不利指数相关,来自国家邻里数据档案馆.
- 应用Poisson空间扫描统计数据来检测抗治疗不足的地理集群,按风险得分分层分.
主要成果:
- 确定了一个重要的地理集群 (P<.001) 治疗不足的外科手术前的反性预防病例.
- 这个群体中的患者接受抗emetics的可能性是1.44倍,控制了抗emetic风险.
- 来自较弱势社区的患者更有可能接受低于中位数的抗emetic预防,即使在风险调整后.
结论:
- 这项研究是首次对外周手术过程差异进行地理空间集群分析.
- 创新的地缘统计方法确定了一个空间定义的患者群体,这些患者经历了抗emetic预防差异.
- 邻居贫困指数预测了风险调整后的抗性预防中的差异,强调了地理位置和护理不平等之间的联系.
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