Correlates of Emergency Department Service Utilization Among U.S. Chinese Older Adults.
Correlates of Emergency Department Service Utilization Among U.S. Chinese Older Adults.
复制标题
美国华人老年人急诊科服务利用的相关性。
DOI：
10.1007/s10903-018-0828-0
复制
发表时间：
2019
影响因子：
1.9
通讯作者：
Dong,Xinqi
中科院分区：
文献类型：
--
作者：
Kong,Dexia;Li,Mengting;Wong,Yin-LingIrene;Wang,Jinjiao;Sun,BenjaminC;Dong,Xinqi
老年人访问急诊室（ED）的比率高于其他年龄组。以前的研究探讨种族差异的艾德利用集中在非洲裔美国人和西班牙裔。尽管有证据表明亚裔美国人的艾德支出与高加索人相当，但关于亚裔美国人老年人艾德利用模式的信息仍然缺乏。为了解决这一知识差距，我们研究了与艾德服务利用相关的因素，在最大的亚洲亚组，美国和中国的老年人。使用来自芝加哥中国老年人人口研究（PINE）（N = 3，157）的横断面数据。进行多变量负二项回归分析，以检查与艾德使用相关的重要因素。高等教育（率比[RR] = 1.03，95%置信区间[CI] 1.00-1.05）和文化适应水平（RR = 1.02，CI 1.00-1.04），家庭人口较少（RR = 0.94，CI 0.88-0.99），健康保险覆盖率（RR = 1.34，CI 1.01-1.78），收入较低（RR = 0.89，CI 0.80-0.99），自感健康较差（RR = 0.67，CI 0.58-0.77），更多功能受限（RR = 1.09，CI 1.06-1.13）与抑郁症状（RR = 1.04，CI 1.02-1.07）和心脏病史（RR = 2.28，CI 1.83-2.84）、卒中（RR = 1.68，CI 1.20-2.35）、癌症（RR = 1.86，CI 1.31-2.63）和髋部骨折（RR = 1.42，CI 1.02-1.98）与较高的艾德就诊率相关。我们的研究结果强调了美国和中国老年人使用艾德的几个重要相关性。文化上适当的干预措施修改这些因素有可能减少艾德访问和改善护理结果在这一人群。
Older adults visit emergency departments (EDs) at a disproportionally higher rate than other age groups. Prior studies examining racial disparities in ED utilization focus on African Americans and Hispanics. There is a dearth of information on ED utilization patterns among older Asian Americans despite the evidence that ED expenditures in Asian Americans are comparable to that of Caucasians. To address this knowledge gap, we examined factors associated with ED service utilization in the largest Asian subgroup, U.S. Chinese older adults. Cross-sectional data from the Population Study of Chinese Elderly in Chicago (PINE) (N = 3,157) were used. Multivariate negative binomial regression analyses were conducted to examine significant factors associated with ED use. Higher education (rate ratio [RR] = 1.03, 95% confidence interval [CI] 1.00–1.05) and acculturation levels (RR = 1.02, CI 1.00–1.04), fewer people in the household (RR = 0.94, CI 0.88–0.99), health insurance coverage (RR = 1.34, CI 1.01–1.78), lower income (RR = 0.89, CI 0.80–0.99), poorer perceived health (RR = 0.67, CI 0.58–0.77), more functional limitations (RR = 1.09, CI 1.06–1.13) and depressive symptoms (RR = 1.04, CI 1.02–1.07), and a history of heart disease (RR = 2.28, CI 1.83–2.84), stroke (RR = 1.68, CI 1.20–2.35), cancer (RR = 1.86, CI 1.31–2.63), and hip fracture (RR = 1.42, CI 1.02–1.98) were associated with higher rates of ED visits. Our findings highlight several significant correlates of ED use in U.S. Chinese older adults. Culturally-appropriate interventions modifying these factors have the potential to decrease ED visits and improve care outcomes in this population.