Emergency Department Use in the US-Mexico Border Region and Violence in Mexico: Is There a Relationship?
Emergency Department Use in the US-Mexico Border Region and Violence in Mexico: Is There a Relationship?
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美墨边境地区的急诊室使用情况与墨西哥的暴力事件：有关系吗？
DOI：
10.1111/jrh.12109
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Holmes,GeorgeM
中科院分区：
文献类型：
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作者：
Geissler,KimberleyH;Holmes,GeorgeM
目的本研究评估了墨西哥北方凶杀率与美墨边境地区可能避免使用急诊科（艾德）之间的关系。边境地区大部分是农村地区，服务不足，因此确定和纠正潜在的障碍至关重要。MethodsWe使用了二级数据从国家住院和艾德出院数据库为加州和亚利桑那州为2005 - 2010年。使用广义线性模型进行回顾性观察分析，以确定是否有可能发生艾德事件是可以避免的，这与最近的墨西哥城市的凶杀率有关。为了进行分析，确定了艾德遭遇的地点，并与最近的墨西哥城市的凶杀率和地区特征进行了匹配。的概率，一个艾德遇到潜在的可避免的计算使用比林斯艾德algorithm.FindingsWe发现，77%的艾德遇到潜在的可避免的，在边境县的比例较高。对于完整的分析样本（n = 24，859，273）和样本中未投保和投保不足的人群（n = 11，700，123），凶杀率和艾德遭遇是潜在可避免条件的概率之间没有统计学显著关系。然而，在北方墨西哥的凶杀率和亚利桑那州和加州的艾德排放分布之间没有很强的关系。考虑到可能避免的艾德遭遇的比例很大，以及墨西哥持续的暴力事件，继续监测这种关系很重要。
PurposeThis study assessed the association between homicide rates in northern Mexico and potentially avoidable use of emergency departments (ED) in the US‐Mexico border region. The border region is largely rural and underserved, making the identification and correction of potential barriers to access crucial.MethodsWe used secondary data from state inpatient and ED discharge databases for California and Arizona for 2005‐2010. A retrospective observational analysis using generalized linear models was used to determine whether the probability that an ED encounter was potentially avoidable was associated with homicide rates in the nearest Mexican municipality. To conduct the analysis, the location of ED encounters were identified and matched with homicide rates in the nearest Mexican municipality and regional characteristics. The probability that an ED encounter was potentially avoidable was calculated using the Billings ED algorithm.FindingsWe found that 77% of ED encounters were potentially avoidable, with a higher percentage in border counties. There was no statistically significant relationship between homicide rates and the probability that an ED encounter was for a potentially avoidable condition for the full analytic sample (n = 24,859,273) and the uninsured and underinsured in the sample (n = 11,700,123).ConclusionA substantial majority of ED encounters in the US‐Mexico border region were potentially avoidable. However, there was not a strong relationship between homicide rates in northern Mexico and the distribution of ED discharges in Arizona and California. Given the large percentage of potentially avoidable ED encounters and the ongoing violence in Mexico, continuing to monitor this relationship is important.