Household and area determinants of emergency department attendance and hospitalisation in people with multimorbidity: a systematic review.
Household and area determinants of emergency department attendance and hospitalisation in people with multimorbidity: a systematic review.
复制标题
DOI：
10.1136/bmjopen-2022-063441
复制
发表时间：
2022-10-03
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
--
作者：
多重死亡是国际医疗保健面临的最大挑战之一。急诊科（艾德）的出勤率和住院率较高的人患有多发性硬化症，但大多数研究都集中在与个人特征的关联，忽略了家庭或地区调解人的服务使用。系统性综述报告采用无荟萃分析框架的综合。12个电子数据库（2000年1月1日至2021年9月21日）：MEDLINE/奥维德、Embase、全球健康、PsycINFO、ASSIA、CAB摘要、科学引文索引扩展/ISI科学网、Scopus、护理和相关健康文献累积索引、社会学摘要、科克伦图书馆和OpenGrey。年龄≥16岁的成人，患有多发性骨髓瘤。暴露是家庭和/或地区健康的决定因素。结局为艾德就诊和/或住院。文献检索仅限于英文出版物。标题和摘要的独立双重筛选，以选择相关的全文研究。方法学质量进行了评估，使用适应的纽卡斯尔-渥太华质量评估量表工具。鉴于研究异质性较高，进行了叙述性综合。重复数据删除后，筛选了10 721篇标题和摘要，审查了142篇全文文章，其中10篇符合纳入条件。在多发病人群中，家庭粮食不安全与住院相关（一致多发病中OR 1.58（95%CI 1.06 - 2.36））。生活在最贫困地区与最不贫困地区的多发性硬化症患者更频繁地参加艾德（8.9%（95% CI 8.6至9.1），大多数vs 6.3%）（95% CI至少为6.1至6.6）），住院率较高（大多数为26%，最少为22%），住院概率较高（大多数为6.4%（95% CI 5.8 - 7.2），最少为4.2%（95% CI 3.8 - 4.7））。有非决定性的证据表明，家庭收入与艾德出席和住院。在婚姻状况、与多病患者同住或农村与艾德就诊或住院之间没有发现统计学显著关系。有一些证据表明，家庭和地区的背景调解协会的多morphine与艾德出席和住院治疗，但坚定的结论是有限的研究发表的研究数量和研究设计的异质性。需要使用强有力的分析方法对大量人口样本进行进一步研究。CRD 42021283515。
Multimorbidity is one of the greatest challenges facing healthcare internationally. Emergency department (ED) attendance and hospitalisation rates are higher in people with multimorbidity, but most research focuses on associations with individual characteristics, ignoring household or area mediators of service use. Systematic review reported using the synthesis without meta-analysis framework. Twelve electronic databases (1 January 2000–21 September 2021): MEDLINE/OVID, Embase, Global Health, PsycINFO, ASSIA, CAB Abstracts, Science Citation Index Expanded/ISI Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, the Cochrane Library, and OpenGrey. Adults aged ≥16 years, with multimorbidity. Exposure(s) were household and/or area determinants of health. Outcomes were ED attendance and/or hospitalisation. The literature search was limited to publications in English. Independent double screening of titles and abstracts to select relevant full-text studies. Methodological quality was assessed using an adaptation of the Newcastle-Ottawa Quality Assessment Scale tool. Given high study heterogeneity, narrative synthesis was performed. After deduplication, 10 721 titles and abstracts were screened, and 142 full-text articles were reviewed, of which 10 were eligible for inclusion. In people with multimorbidity, household food insecurity was associated with hospitalisation (OR 1.58 (95% CI 1.06 to 2.36) in concordant multimorbidity). People with multimorbidity living in the most versus least deprived areas attended ED more frequently (8.9% (95% CI 8.6 to 9.1) in most versus 6.3% (95% CI 6.1 to 6.6) in least), had higher rates of hospitalisation (26% in most versus 22% in least), and higher probability of hospitalisation (6.4% (95% CI 5.8 to 7.2) in most versus 4.2% (95% CI 3.8 to 4.7) in least). There was non-conclusive evidence that household income is associated with ED attendance and hospitalisation. No statistically significant relationships were found between marital status, living with others with multimorbidity, or rurality with ED attendance or hospitalisation. There is some evidence that household and area contexts mediate associations of multimorbidity with ED attendance and hospitalisation, but firm conclusions are constrained by the small number of studies published and study design heterogeneity. Further research is required on large population samples using robust analytical methods. CRD42021283515.
登录
查看更多内容
影响因子：
5.4
作者：
Griffin, Edward;McCarthy, John P.;Kingham, Simon
通讯作者：
Kingham, Simon
DOI：
10.1192/bjp.bp.112.119164
发表时间：
2013-01-01
期刊：
The British journal of psychiatry. Supplement
影响因子：
--
作者：
Jones, P B
通讯作者：
Jones, P B
影响因子：
10
作者：
Bu, Feifei;Philip, Keir;Fancourt, Daisy
通讯作者：
Fancourt, Daisy
影响因子：
2.9
作者：
Luben, Robert;Hayat, Shabina;Khaw, Kay-Tee
通讯作者：
Khaw, Kay-Tee
影响因子：
4.5
作者：
Orueta, Juan F.;Garcia-Alvarez, Arturo;Nuno-Solinis, Roberto
通讯作者：
Nuno-Solinis, Roberto