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健康素养干预对儿科急诊科就诊的影响。

Impact of a health literacy intervention on pediatric emergency department use.

作者信息

Herman Ariella, Young Kelly D, Espitia Dennis, Fu Nancy, Farshidi Arta

机构信息

UCLA Anderson School of Management, Los Angeles, CA, USA.

出版信息

Pediatr Emerg Care. 2009 Jul;25(7):434-8. doi: 10.1097/PEC.0b013e3181ab78c7.

Abstract

OBJECTIVE

The aim of this study was to measure the impact of a simple parent health literacy intervention on emergency department and primary care clinic usage patterns.

METHODS

Study participants consisted of parents who brought their children to the Harbor-UCLA Medical Center pediatric emergency department for nonurgent complaints. Study participants filled out questionnaires regarding their management of children's mild health complaints and where respondents first seek help when their children become sick. After completing the questionnaires, participants were educated about how to use the health aid book What to Do When Your Child Gets Sick and provided a free copy. After 6 months, telephone follow-up interviews were conducted to assess whether the health literacy intervention had influenced the participants' management of their children's mild health complaints and their health care resource usage patterns.

RESULTS

One hundred thirteen parents were enrolled in the preintervention phase, and 61 were successfully interviewed at 6 months by telephone. Before and after comparisons demonstrated a 13% reduction in the percentage of respondents who stated they would go to the emergency department first if their child became sick. In addition, 30% fewer respondents reported actual visits to the emergency department in the previous 6 months. Regarding specific low-acuity scenarios, significantly fewer participants would take their child to the emergency department for a low-grade fever with a temperature of 99.5 degrees F and for vomiting for 1 day. There was no significant change in the proportion of parents who would take their child to the emergency department for earache or cough.

CONCLUSIONS

Health literacy interventions may reduce nonurgent emergency department visits and help mitigate emergency department overcrowding and the rising costs of health care.

摘要

目的

本研究旨在衡量一项简单的家长健康素养干预措施对急诊科和初级保健诊所就诊模式的影响。

方法

研究参与者为带孩子前往哈伯-加州大学洛杉矶分校医学中心儿科急诊科就诊非紧急病症的家长。研究参与者填写了关于其对孩子轻度健康问题的处理方式以及孩子生病时他们首先会寻求帮助的地点的问卷。完成问卷后,参与者接受了关于如何使用健康援助书籍《孩子生病怎么办》的教育,并获赠一本免费书籍。6个月后,进行电话随访访谈,以评估健康素养干预措施是否影响了参与者对孩子轻度健康问题的处理方式及其医疗资源使用模式。

结果

113名家长参与了干预前阶段,61名在6个月时成功接受了电话访谈。前后比较显示,称孩子生病时会首先前往急诊科的受访者比例降低了13%。此外,在前6个月中,报告实际前往急诊科就诊的受访者减少了30%。对于特定的低急症情况,因体温99.5华氏度的低热和呕吐1天而带孩子前往急诊科的参与者明显减少。因耳痛或咳嗽带孩子前往急诊科的家长比例没有显著变化。

结论

健康素养干预措施可能会减少非紧急的急诊科就诊,有助于缓解急诊科拥挤状况以及医疗保健成本的不断上升。

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