Adolescents who use the emergency department as their usual source of care
Adolescents who use the emergency department as their usual source of care
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DOI：
10.1001/archpedi.154.4.361
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发表时间：
2000-04-01
影响因子：
--
通讯作者：
Klein, JD
中科院分区：
文献类型：
--
作者：
Wilson, KM;Klein, JD
目的：探讨与使用急诊室 (ED) 作为青少年唯一的医疗保健来源相关的因素。 设计：对 1997 年联邦基金青春期女孩健康调查的分析，该调查是全国范围内具有代表性的 6748 名 5 至 12 年级在校男女青少年样本。使用 SUDAAN 计算 chi(2) 统计数据和逻辑回归分析。结果：总体而言，调查中 4.6% 的青少年（即美国 150 万青少年）报告说，急诊室是他们通常的医疗保健来源。在多变量模型中，与使用 ED 相关的因素包括男性、非裔美国人、经济资源较少以及居住在农村地区。具有较高危险行为水平、有身体虐待或性虐待历史以及较高抑郁评分的青少年更有可能将急诊室作为他们通常的护理来源。与使用其他初级保健来源的青少年相比，报告使用急诊室作为常规护理来源的青少年也不太可能定期进行健康检查，并且更有可能报告错过了所需的护理。结论：使用急诊室作为常规护理来源的青少年通常来自弱势群体。许多人有特殊的精神或身体需求，仅靠急诊就诊不可能满足这些需求，而且他们很可能错过了所需的护理。在急诊室和其他服务之间建立联系可以帮助高危青少年识别和使用更合适的初级保健来源。
Objective: To examine the factors associated with use of the emergency department (ED) as the only source of health care among adolescents.Design: Analyses of the 1997 Commonwealth Fund Survey of the Health of Adolescent Girls, a nationally representative sample of 6748 in-school male and female adolescents in 5th through 12th grade. The chi(2) statistics and logistic regression analyses were computed with the use of SUDAAN.Results: Overall, 4.6% of the adolescents in the survey, or 1.5 million adolescents in the United States, reported that the ED was their usual source of health care. In multivariate models, factors associated with the use of the ED included male sex, African American ethnicity, fewer financial resources, and living in a rural area. Adolescents with higher levels of risky behaviors, a history of physical or sexual abuse, and higher depression scores were all more likely to use the ED as their usual source of care. Adolescents who reported using the ED as their usual care source were also less likely to have had regular well visits and were more likely to report having missed needed care than those with other sources of primary care.Conclusions: Adolescents who use the ED as their usual source of care are often from vulnerable populations. Many have special mental or physical needs that are unlikely to be met with ED visits only, and they are likely to have missed care they needed. Creating linkages between EDs and other sen ices could help at-risk adolescents identify and use more appropriate sources of primary care.