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患有多种慢性病的人群中频繁急诊就诊的性别差异。

Sex differences in frequent ED use among those with multimorbid chronic diseases.

作者信息

Milani Sadaf A, Crooke Hannah, Cottler Linda B, Striley Catherine W

机构信息

University of Florida, College of Public Health and Health Professions & College of Medicine, Department of Epidemiology.

University of Florida, College of Public Health and Health Professions & College of Medicine, Department of Epidemiology.

出版信息

Am J Emerg Med. 2016 Nov;34(11):2127-2131. doi: 10.1016/j.ajem.2016.07.059. Epub 2016 Aug 3.

Abstract

OBJECTIVES

The objectives were to examine the association between multimorbid chronic disease and frequency of past 6 months emergency department (ED) visits, by sex, in a community sample of adults from North Florida (N=7143).

METHODS

Data came from HealthStreet, a community engagement program at the University of Florida which uses the Community Health Worker Model to assess community member health conditions and concerns, and willingness to participate in health research. Using logistic regression, we estimated associations between multimorbid chronic disease and frequent ED use using sex as an effect modifier.

RESULTS

Multimorbid chronic disease was associated with frequent ED use overall, with a stronger association among men. Of the 7143 respondents, 14.4% were frequent ED users, 58.0% were female, and 61.5% were black non-Hispanic. Major findings included that women with 3+ chronic diseases were 2.49 (95% confidence interval, 1.7-3.6) times as likely as women without chronic diseases to report frequent ED use, compared with men with 3+ chronic diseases, who were 4.98 (95% confidence interval, 2.9-8.6) times as likely as men without chronic disease to report frequent ED use.

CONCLUSIONS

Multimorbid chronic disease is very strongly associated with frequent ED use among all, but the association is especially strong among men. Future research is needed to further understand this association and its implication for health care.

摘要

目的

本研究旨在考察佛罗里达州北部社区成年样本(N = 7143)中,多慢性病与过去6个月内急诊就诊频率之间的关联,并按性别进行分析。

方法

数据来自佛罗里达大学的社区参与项目HealthStreet,该项目采用社区卫生工作者模式来评估社区成员的健康状况、担忧以及参与健康研究的意愿。我们使用逻辑回归,以性别作为效应修饰因素,估计多慢性病与频繁急诊就诊之间的关联。

结果

总体而言,多慢性病与频繁急诊就诊相关,男性中的关联更强。在7143名受访者中,14.4%为频繁急诊使用者,58.0%为女性,61.5%为非西班牙裔黑人。主要研究结果包括,患有3种及以上慢性病的女性报告频繁急诊就诊的可能性是无慢性病女性的2.49倍(95%置信区间为1.7 - 3.6),而患有3种及以上慢性病的男性报告频繁急诊就诊的可能性是无慢性病男性的4.98倍(95%置信区间为2.9 - 8.6)。

结论

多慢性病与所有人的频繁急诊就诊密切相关,但这种关联在男性中尤为强烈。未来需要进一步研究以深入了解这种关联及其对医疗保健的影响。

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