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秘鲁2007年伊卡地震后的医疗服务可及性与就医行为

Access to health services and care-seeking behaviors after the 2007 Ica earthquake in Peru.

作者信息

Daniels Amy, Chapin Erica, Aspilcueta Daniel, Doocy Shannon

机构信息

Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.

出版信息

Disaster Med Public Health Prep. 2009 Jun;3(2):97-103. doi: 10.1097/DMP.0b013e3181a20328.

Abstract

OBJECTIVE

To assess care-seeking behaviors, perceptions of quality, and access to health services among populations affected by the 2007 Peruvian earthquake.

METHODS

A stratified cluster survey design was used to allow for comparison between urban, periurban, and rural populations of the 4 provinces most affected by the earthquake. Forty-two clusters of 16 households (n = 672) were interviewed approximately 6 months after the earthquake.

RESULTS

Of all of the respondents, 38% reported that a household member sought medical care within 2 weeks after the earthquake. Earthquake-related injury, presence of a chronic medical condition, and residence in temporary housing were significantly associated with care seeking in adjusted models. Individuals experiencing earthquake-related injuries and those with chronic medical conditions, respectively, were 7.1 times (95% confidence interval [CI] 3.7-13.7) and 1.9 times (95% CI 1.3-2.9) more likely to seek medical care; temporary housing residents were 1.7 times (95% CI 1.0-2.8) more likely to seek care than those residing in permanent housing.

CONCLUSIONS

Earthquake-related injury and chronic medical conditions were associated with care seeking in the first 2 weeks after the 2007 Ica earthquake. Households living in temporary housing were more likely to seek medical care than those residing in permanent structures, suggesting that displaced people are more likely to need medical attention.

摘要

目的

评估2007年秘鲁地震受灾人群的就医行为、对医疗质量的认知以及获得医疗服务的情况。

方法

采用分层整群抽样调查设计,以便对受地震影响最严重的4个省份的城市、城郊和农村人口进行比较。在地震发生约6个月后,对42个群组的16户家庭(n = 672)进行了访谈。

结果

在所有受访者中,38%报告称有家庭成员在地震后2周内寻求过医疗护理。在调整后的模型中,与地震相关的损伤、慢性疾病的存在以及居住在临时住房与就医显著相关。经历与地震相关损伤的个体和患有慢性疾病的个体分别比未经历者就医可能性高7.1倍(95%置信区间[CI] 3.7 - 13.7)和1.9倍(95% CI 1.3 - 2.9);居住在临时住房的居民比居住在永久住房的居民就医可能性高1.7倍(95% CI 1.0 - 2.8)。

结论

与地震相关的损伤和慢性疾病与2007年伊卡地震后前2周的就医情况相关。居住在临时住房的家庭比居住在永久建筑中的家庭更有可能寻求医疗护理,这表明流离失所者更有可能需要医疗关注。

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