Beitler Alan L, Junnila Jennifer L, Meyer James H
Department of Surgery, New Jersey Health Care System, East Orange 07018-1095, USA.
Mil Med. 2006 Sep;171(9):889-93. doi: 10.7205/milmed.171.9.889.
To examine the clinical effectiveness of patient encounters during humanitarian assistance (HA) missions performed by the 48th Combat Support Hospital in Afghanistan.
Data were prospectively gathered from missions in the villages of Aroki (January 21, 2003), Tangee (March 25, 2003), and Turkman (April 22, 2003). Health care providers evaluated the effectiveness of each patient encounter using a data-gathering instrument with clearly defined outcome measures.
A total of 1,887 patients were seen during the three missions. Forms were incomplete for 112 patients and not used for 33 dental patients. For the remaining 1,742 individuals, probable cures were achieved as follows: adult males, 31%; adult females, 52%; male children, 46%; and female children, 54% (all patients, 46%, p < 0.001). After adjusting for acute care that was supportive in nature during the final mission, probable cures were achieved as follows: adult males, 22%; adult females, 16%; male children, 34%; and female children, 27%. During this final operation, 73% (p < 0.001) of patients received care that was unnecessary, unlikely to produce a cure, or was merely supportive in nature.
During HA missions performed by the 48th Combat Support Hospital, the majority of patient encounters did not result in curative treatments. The effectiveness of medical care during HA missions cannot be assumed and future operations should include assessments of outcomes to optimize their value.
研究第48战斗支援医院在阿富汗执行人道主义援助任务期间患者诊疗的临床效果。
前瞻性收集2003年1月21日在阿罗基村、2003年3月25日在坦吉村以及2003年4月22日在土库曼村执行任务期间的数据。医护人员使用具有明确结局指标的数据收集工具评估每次患者诊疗的效果。
在这三次任务中，共诊疗了1887名患者。112名患者的表格填写不完整，33名牙科患者的表格未使用。对于其余1742名患者，实现可能治愈的比例如下：成年男性为31%；成年女性为52%；男童为46%；女童为54%（所有患者为46%，p<0.001）。在对最后一次任务期间本质上具有支持性的急性护理进行调整后，实现可能治愈的比例如下：成年男性为22%；成年女性为16%；男童为34%；女童为27%。在这次最后行动中，73%（p<0.001）的患者接受了不必要、不太可能治愈或本质上仅具有支持性的护理。
在第48战斗支援医院执行人道主义援助任务期间，大多数患者诊疗并未带来治愈性治疗。不能想当然地认为人道主义援助任务期间医疗护理的效果，未来行动应包括对结果进行评估，以优化其价值。
