Demographic predictors of emergency service utilization patterns in youth at risk of suicide.
Demographic predictors of emergency service utilization patterns in youth at risk of suicide.
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有自杀风险的青少年的紧急服务利用模式的人口统计预测因素。
DOI：
10.1111/sltb.12975
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发表时间：
2023
影响因子：
3.2
通讯作者：
Haroz,EmilyE
中科院分区：
文献类型：
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作者：
Bajaj,MiraA;Wilcox,HollyC;Adams,LeslieB;Berman,AlanL;Cwik,Mary;Kitchen,Christopher;Miller,Leslie;Nestadt,PaulS;Slade,EricP;Haroz,EmilyE
目的探讨有自杀史青年急诊科（艾德）利用的人口学预测因素（即，从2017年至2021年，在大西洋中部的一个城市学术医疗中心艾德提取了3094名8-22岁有自杀史的患者的电子健康记录。Logistic回归分析用于评估人口统计学预测因素的艾德使用频率，后续访问的时间，以及后续访问的原因超过24个月的随访期。（OR = 1.45，95%CI = 1.11-1.92），女性（OR = 1.59，95%CI = 1.26-2.03），且有医疗保险（OR = 1.71，95%CI = 1.37-2.14）与利用率增加相关，而18岁以下与利用率降低相关（<12：OR = 0.38，95%CI = 0.26-0.56; 12-18：OR = 0.47，95%CI = 0.35-0.63）。这些人口统计数据也与艾德再入院90天内，而在18岁以下是与一个较低的几率再入院。ConclusionsAmong患者的自杀史，那些谁确定为黑人，年轻的成年人，医疗补助的患者，女性患者更有可能是频繁利用的艾德在2年内，他们的首次访问。这种模式可能表明，这些群体的医疗保健服务不足，需要发展更好的医疗协调与交叉重点，以促进利用其他卫生服务。
ObjectiveTo explore demographic predictors of Emergency Department (ED) utilization among youth with a history of suicidality (i.e., ideation or behaviors).MethodsElectronic health records were extracted from 2017 to 2021 for 3094 8–22 year‐old patients with a history of suicidality at an urban academic medical center ED in the Mid‐Atlantic. Logistic regression analyses were used to assess for demographic predictors of ED utilization frequency, timing of subsequent visits, and reasons for subsequent visits over a 24‐month follow‐up period.ResultsBlack race (OR = 1.45, 95% CI = 1.11–1.92), Female sex (OR = 1.59, 95% CI = 1.26–2.03), and having Medicaid insurance (OR = 1.71, 95% CI = 1.37–2.14) were associated with increased utilization, while being under 18 was associated with lower utilization (<12: OR = 0.38, 95% CI = 0.26–0.56; 12–18: OR = 0.47, 95% CI = 0.35–0.63). These demographics were also associated with ED readmission within 90 days, while being under 18 was associated with a lower odds of readmission.ConclusionsAmong patients with a history of suicidality, those who identify as Black, young adults, patients with Medicaid, and female patients were more likely to be frequent utilizers of the ED within the 2 years following their initial visit. This pattern may suggest inadequate health care access for these groups, and a need to develop better care coordination with an intersectional focus to facilitate utilization of other health services.