The Influence of Social Determinants of Health on Emergency Departments Visits in a Medicaid Sample.
The Influence of Social Determinants of Health on Emergency Departments Visits in a Medicaid Sample.
复制标题
健康决定因素对医疗补助样本中急诊室访问的影响。
DOI：
10.1016/j.annemergmed.2020.11.010
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发表时间：
2021-05
影响因子：
6.2
通讯作者：
Zeger, Scott L.
中科院分区：
文献类型：
--
作者：
McCarthy, Melissa L.;Zheng, Zhaonian;Wilder, Marcee E.;Elmi, Angelo;Li, Yixuan;Zeger, Scott L.
评价哥伦比亚特区医疗补助队列中健康社会决定因素（SDH）与急诊科（艾德）就诊之间的关系。我们对8，943名在研究入组时完成SDH调查的成年医疗补助受益人进行了回顾性队列分析。我们将SDH数据与参与者的医疗补助索赔数据在入组前长达24个月合并。使用潜在类别分析，我们将参与者分为四个不同的社会风险类别，基于对SDH问题的类似反应。我们使用明尼苏达算法将艾德就诊分类为初级保健可治疗（PCT）或艾德需要护理（EDCN）。我们使用广义线性混合效应模型计算了社会风险类别中校正的对数相对PCT和EDCN访视率。在8，943名参与者进行的49，111次艾德访视中，大多数（71%）是EDCN。PCT和EDCN访视率的校正对数相对率随着社会风险等级的升高（更差）而升高（与最低等级相比）。最高社会风险类别（即失业和许多社会风险）的参与者的对数相对PCT和EDCN率分别为39%（28% - 50%）和29%（21%和38%），调整了年龄，性别和疾病严重程度。在这个医疗补助样本中，健康和艾德利用的社会决定因素之间存在很强的关系，值得在其他医疗补助样本和患者人群中进行调查。
To evaluate the relationship between social determinants of health (SDH) and emergency department (ED) visits in the Medicaid Cohort of the District of Columbia. We conducted a retrospective cohort analysis of 8,943 adult Medicaid beneficiaries who completed a SDH survey at time of study enrollment. We merged the SDH data with participants’ Medicaid claims data for up to 24 months prior to enrollment. Using latent class analysis, we grouped our participants into four distinct social risk classes based on similar responses to the SDH questions. We classified ED visits as primary care treatable (PCT) or ED care needed (EDCN) using the Minnesota algorithm. We calculated the adjusted log relative PCT and EDCN visit rates among the social risk classes using generalized linear mixed effects models. The majority (71%) of the 49,111 ED visits made by the 8,943 participants were EDCN. The adjusted log relative rate of both PCT and EDCN visit rates increased with each higher (worse) social risk class compared to the lowest class. Participants in the highest social risk class (i.e. unemployed and many social risks) had a log relative PCT and EDCN rate of 39% (28% – 50%) and 29% (21% and 38%) respectively, adjusted for age, sex and illness severity. There is a strong relationship between social determinants of health and ED utilization in this Medicaid sample that is worth investigating in other Medicaid samples and patient populations.
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DOI：
10.1016/j.hjdsi.2015.05.003
发表时间：
2016-06-01
影响因子：
2.5
作者：
Lee, David C.;Doran, Kelly M.;Carr, Brendan G.
通讯作者：
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影响因子：
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影响因子：
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作者：
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影响因子：
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作者：
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