Care of injection drug users with soft tissue, infections in San Francisco, California
Care of injection drug users with soft tissue, infections in San Francisco, California
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DOI：
10.1001/archsurg.137.11.1217
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发表时间：
2002-11-01
影响因子：
--
通讯作者：
Young, DM
中科院分区：
文献类型：
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作者：
Harris, HW;Young, DM
内容：非法注射毒品导致严重的软组织感染，这是第一号非精神病原因入院的旧金山弗朗西斯科总医院（SFGH），旧金山弗朗西斯科，加利福尼亚州。目的：建立一个专门的诊所，提供方便，高质量，具有成本效益的医疗护理软组织感染的患者。设计，设置，干预和结果措施：综合软组织感染服务（ISIS）诊所的成立是为了提供协调的手术干预，药物滥用咨询，并为在公立医院治疗的软组织感染患者的社会服务。人口统计信息，治疗结果，和医院利用率data.Results进行了分析：在诊所的第一年的操作，有3365名患者就诊和2255外科手术。大量患者报告最近注射非法药物（61%），无家可归（30%），并患有丙型肝炎、B型肝炎或人类免疫缺陷病毒感染（62%）。使用海洛因的患者参加了戒毒或维持计划（42%）。少数患者被指定为治疗失败（2%）或失访（14%）。ISIS诊所大大减少了急诊科就诊（-33.9%），手术服务入院（-47.3%），住院急性护理床天数（-33.7%），手术室程序（-71%），节省约$8 765 200在第一年的operation.Conclusions：这种临床干预是显着的成本效益，同时保持高质量的医疗服务。由于数据有限，我们只能假设其他社区也同样面临这一公共卫生问题。ISIS诊所可以作为一种模式干预，从而对治疗这一普遍但经常被忽视的挑战产生重大影响。
Context: Illicit injection drug use results in serious soft tissue infections that are the number one nonpsychiatric reason for admission to San Francisco General Hospital (SFGH), San Francisco, Calif.Objective: To establish a specialized clinic to provide accessible, high-quality, and cost-effective medical care to patients with soft tissue infections.Design, Setting, Intervention, and Outcome Measures: The Integrated Soft Tissue Infection Services (ISIS) Clinic was established to provide coordinated surgical intervention, substance abuse counseling, and social services for patients with soft tissue infections treated in a public hospital. Demographic information, treatment outcome, and hospital utilization data were analyzed.Results: In the clinic's first year of operation, there were 3365 patient visits and 2255 surgical procedures. A large number of patients reported recent injection of illicit drugs (61%), were homeless (30%), and either had hepatitis C, hepatitis B, or human immunodeficiency virus infection (62%). Patients using heroin were enrolled in either a detoxification or maintenance program (42%). Few patients were designated as treatment failures (2%) or were lost to follow-up (14%). The ISIS Clinic dramatically reduced emergency department visits (-33.9%), surgical service admissions (-47.3%), inpatient acute care bed days (-33.7%), and operating room procedures (-71%), saving approximately $8 765 200 in the first year of operation.Conclusions: This clinical intervention was notably cost-effective while preserving a high quality of medical services. Owing to limited data, we can only assume that other communities are similarly confronted with this public health problem. The ISIS Clinic could serve as a model intervention and thus have significant impact on the treatment of this prevalent but often overlooked challenge.