Pulse Oximetry Screening: Association of State Mandates with Emergency Hospitalizations.
Pulse Oximetry Screening: Association of State Mandates with Emergency Hospitalizations.
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脉搏血氧饱和度筛查：国家授权与紧急住院治疗的关联。
DOI：
10.1007/s00246-022-03027-3
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发表时间：
2023
影响因子：
1.6
通讯作者：
Chang,Ruey-KangR
中科院分区：
文献类型：
--
作者：
Sakai-Bizmark,Rie;Kumamaru,Hiraku;Marr,EmilyH;Bedel,LaurenEM;Mena,LaurieA;Baghaee,Anita;Nguyen,Michael;Estevez,Dennys;Wu,Frank;Chang,Ruey-KangR
我们评估了实施国家规定的脉搏血氧饱和度筛查 (POS) 与患有严重先天性心脏病 (CCHD) 的婴儿紧急住院率之间的关联，并评估了不同种族/民族之间这种关联的差异。我们假设，实施强制 POS 后，患有 CCHD 的婴儿的紧急住院人数有所减少，并且与非西班牙裔白人相比，少数种族和族裔的减少幅度更大。我们利用了亚利桑那州、加利福尼亚州、肯塔基州、新泽西州、纽约州和华盛顿州的全州住院患者数据库（2010-2014 年）。使用具有负二项式回归的双重差分模型。我们确定了出生后三天到三个月内住院的 CCHD 患者被编码为“紧急”或“紧急”或通过急诊科住院。按月份和州汇总的紧急住院人数被用作结果。干预变量是国家规定的 POS 的实施。通过指示强制政策期限的二元变量与每个种族/民族群体之间的交互项来评估跨种族/民族关联的差异。该模型根据各州特定变量进行了调整，例如女婴百分比和私人保险百分比。我们确定了 9,147 名 CCHD 紧急住院患者。在非西班牙裔白人中，实施强制 POS 后，CCHD 紧急住院率平均下降了 22%（置信区间 [CI] 6%–36%）。与非西班牙裔白人相比，非西班牙裔黑人的下降幅度要低 65%。我们的研究发现，与白人婴儿相比，黑人婴儿紧急住院次数减少的关联性减弱。需要进一步研究来澄清这种差异。
We evaluated the association between implementation of state-mandated pulse oximetry screening (POS) and rates of emergency hospitalizations among infants with Critical Congenital Heart Disease (CCHD) and assessed differences in that association across race/ethnicity. We hypothesized that emergency hospitalizations among infants with CCHD decreased after implementation of mandated POS and that the reduction was larger among racial and ethnic minorities compared to non-Hispanic Whites. We utilized statewide inpatient databases from Arizona, California, Kentucky, New Jersey, New York, and Washington State (2010–2014). A difference-in-differences model with negative binomial regression was used. We identified patients with CCHD whose hospitalizations between three days and three months of life were coded as “emergency” or “urgent” or occurred through the emergency department. Numbers of emergency hospitalizations aggregated by month and state were used as outcomes. The intervention variable was an implementation of state-mandated POS. Difference in association across race/ethnicity was evaluated with interaction terms between the binary variable indicating the mandatory policy period and each race/ethnicity group. The model was adjusted for state-specific variables, such as percent of female infants and percent of private insurance. We identified 9,147 CCHD emergency hospitalizations. Among non-Hispanic Whites, there was a 22% (Confidence Interval [CI] 6%–36%) decline inCCHD emergency hospitalizationsafter implementation of mandated POS, on average. This decline was 65% less among non-Hispanic Blacks compared to non-Hispanic Whites. Our study detected an attenuated association with decreased number of emergency hospitalizations among Black compared to White infants. Further research is needed to clarify this disparity.
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