Concentration of hospital care for acute sickle cell disease-related visits.
Concentration of hospital care for acute sickle cell disease-related visits.
复制标题
急性镰状细胞疾病相关的就诊的医院护理浓度。
DOI：
10.1002/pbc.24028
复制
发表时间：
2012-10
影响因子：
3.2
通讯作者：
Brousseau, D. C.
中科院分区：
文献类型：
--
作者：
Panepinto, J. A.;Owens, P. L.;Mosso, A. L.;Steiner, C. A.;Brousseau, D. C.
镰状细胞病（SCD）的特点是频繁的疾病相关事件，需要紧急护理。目前尚不清楚患者在多大程度上利用多家医院进行急诊护理。我们研究了急性护理访问医院或急诊科的连续性模式。我们假设，在多次SCD相关急性护理就诊的患者中，儿童比成人经历更集中的医院护理，私人保险患者比医疗保险患者经历更集中的医院护理。我们使用2005年和2006年医疗成本和利用项目州住院患者数据库和州急诊部门数据库的数据进行了一项回顾性队列研究。受试者包括年龄≥1岁的SCD患者。主要结局是在一家医院接受多次急诊治疗的患者比例。共有13，533例患者进行了≥ 2次急性SCD相关访视。在5，030名儿童中，77.3%的儿童在所有就诊时都去同一家医院。相比之下，在8,503名成年人中，只有51.3%的人去同一家医院。青少年比成年人更有可能去一家医院（校正相对危险度（ARR）1.40，置信区间（CI）1.35-1.45）。有公共保险的人和没有保险的人使用一家医院的概率降低（ARR0.96，CI 0.94-0.99和ARR0.83，CI 0.79-0.88）。有公共保险或没有保险的成年人和患者更有可能使用多家医院进行急性护理。通过在多家医院接受急诊护理，SCD患者的护理分散且零散，可能导致护理质量下降。
Sickle cell disease (SCD) is characterized by frequent disease-related events that require acute care. It is unknown to what extent patients utilize multiple hospitals for acute care. We examined the continuity pattern of acute care visits to the hospital or emergency department. We hypothesized that among patients with multiple SCD related acute care visits, children experience more concentrated hospital care than adults and privately insured patients experience more concentrated hospital care than publically insured patients. We conducted a retrospective cohort study using data from the 2005 and 2006 Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases. Subjects included patients with SCD ≥1 year of age. The primary outcome was proportion of patients with multiple acute care visits to a single hospital. A total of 13,533 patients made ≥ 2 acute SCD-related visits. Of the 5,030 children, 77.3% went to the same hospital for all visits. In contrast, of the 8,503 adults, only 51.3% visited the same hospital. Adolescents were more likely than adults to go to one hospital (adjusted relative risk (ARR) 1.40, confidence interval (CI) 1.35–1.45). Those with public insurance and the uninsured had a decreased probability of using one hospital (ARR 0.96, CI 0.94–0.99 and ARR 0.83, CI 0.79–0.88 respectively). Adults and patients with public insurance or no insurance are more likely to use multiple hospitals for acute care. By receiving acute care at multiple hospitals, patients with SCD experience dispersed and fragmented care potentially leading to decreased care quality.
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影响因子：
4.4
作者：
Tanabe, Paula;Artz, Nicole;Hafner, John W.
通讯作者：
Hafner, John W.
影响因子：
3.2
作者：
McPherson, Marianne;Thaniel, Lisa;Minniti, Caterina P.
通讯作者：
Minniti, Caterina P.
影响因子：
1.1
作者：
Homer, Charles J.;Cooley, W. Carl;Strickland, Bonnie
通讯作者：
Strickland, Bonnie
影响因子：
5.7
作者：
Haywood, Carlton, Jr.;Lanzkron, Sophie;Beach, Mary Catherine
通讯作者：
Beach, Mary Catherine
影响因子：
--
作者：
Davies, HTO;Crombie, IK;Tavakoli, M
通讯作者：
Tavakoli, M