Assessing the Relationship Between Well-Care Visit and Emergency Department Utilization Among Adolescents and Young Adults.
Assessing the Relationship Between Well-Care Visit and Emergency Department Utilization Among Adolescents and Young Adults.
复制标题
评估青少年和年轻人的护理就诊与急诊科利用之间的关系。
DOI：
10.1016/j.jadohealth.2021.08.011
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Harder,ValerieS
中科院分区：
文献类型：
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作者：
Holland,JenniferE;Varni,SusanE;Pulcini,ChristianD;Simon,TamaraD;Harder,ValerieS
PurposeTo investigate the association between adolescent and young adult（AYA）well care visits and emergency department（艾德）utilization.MethodsVermont's all-payer claims data was used to evaluate visits for 49，089 AYA（年龄12-21岁）with a health care claim from January 1 through December 31，2018.我们进行了多元Logistic回归分析，以确定良好的护理访问和艾德利用之间的关联，调查年龄，保险类型和医疗复杂性的潜在调节作用。没有参加良好护理访问的AYA在2018年至少去一次艾德的几率增加了24%（95%置信区间[CI]：1.19-1.30），控制了年龄，性别，保险类型和医疗复杂性。在调整后的模型中，年龄较大、女性、医疗补助保险和更大的医疗复杂性独立预测了更大的艾德利用率。在分层分析中，晚期青少年和年轻人（18-21岁）没有参加过良好护理访问的人有47%的几率（95% CI：1.37 - 1.58）艾德访视，中年青少年（15-17岁）有9%的几率（95%CI：1.01-1.18）和青少年早期（年龄12-14岁）有16%更大的优势（95%CI：1.06 - 1.26）.ConclusionsNot attending well-care visits is associated with greater艾德utilization among AYAs engaged in health care.重点关注关键的质量绩效指标，如良好的护理访问出席率，特别是18至21岁的人在他们过渡到成人医疗保健，可能有助于减少艾德的利用。
PurposeTo investigate the association between adolescent and young adult (AYA) well-care visits and emergency department (ED) utilization.MethodsVermont's all-payer claims data were used to evaluate visits for 49,089 AYAs (aged 12-21 years) with a health-care claim from January 1 through December 31, 2018. We performed multiple logistic regression analyses to determine the association between well-care visits and ED utilization, investigating potential moderating effects of age, insurance type, and medical complexity.ResultsNearly half (49%) of AYAs who engaged with the health-care system did not attend a well-care visit in 2018. AYAs who did not attend a well-care visit had 24% greater odds (95% confidence interval [CI]: 1.19–1.30) of going to the ED at least once in 2018, controlling for age, sex, insurance type, and medical complexity. Older age, female sex, Medicaid insurance, and greater medical complexity independently predicted greater ED utilization in the adjusted model. In stratified analyses, late adolescents and young adults (aged 18-21 years) who did not attend a well-care visit had 47% greater odds (95% CI: 1.37 - 1.58) of ED visits, middle adolescents (aged 15-17 years) had 9% greater odds (95% CI: 1.01–1.18), and early adolescents (aged 12-14 years) had 16% greater odds (95% CI: 1.06 - 1.26).ConclusionsNot attending well-care visits is associated with greater ED utilization among AYAs engaged in health care. Focus on key quality performance metrics such as well-care visit attendance, especially for 18- to 21-year-olds during their transition to adult health care, may help reduce ED utilization.