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成年难民的情绪困扰、医疗利用与残疾索赔

Emotional Distress, Medical Utilization, and Disability Claims in Adult Refugees.

作者信息

Cronkright Peter, Lupone Christina D

机构信息

Center for Global Health and Translational Science, State University of New York Upstate Medical University, Syracuse, NY, USA.

Department of Medicine, State University of New York Upstate Medical University, Syracuse, NY, USA.

出版信息

J Immigr Minor Health. 2018 Apr;20(2):339-344. doi: 10.1007/s10903-017-0621-5.

Abstract

The refugee health screener-15 (RHS-15) is utilized as a diagnostic proxy for common mental disorders in refugees. Studies are needed to determine its clinical and social utility. A retrospective chart analysis of adult refugees compared RHS-15 scores to utilization of medical services and presence of disability claims. Refugees with negative, positive, and highly positive RHS-15 scores attended 3.1, 4.4, and 5.7 mean primary care visits and 1.6, 2.8, and 4.4 mean non-primary care visits, respectively (p < .000). The 11% (43/392) claiming disability were 5.1 times more likely to have a positive RHS-15 (OR 4.3, 95% CI 2.1-8.8). A positive RHS-15 was not predictive of a disability claim (19% PPV), and those with a negative RHS-15 were unlikely to claim disability (96% NPV). The RHS-15 score correlates with visit utilization. A positive score is not predictive of a subsequent disability claim.

摘要

难民健康筛查量表-15(RHS-15)被用作难民常见精神障碍的诊断替代工具。需要开展研究以确定其临床和社会效用。一项针对成年难民的回顾性病历分析将RHS-15得分与医疗服务利用情况及残疾索赔情况进行了比较。RHS-15得分呈阴性、阳性和高度阳性的难民平均分别进行了3.1次、4.4次和5.7次初级保健就诊以及1.6次、2.8次和4.4次非初级保健就诊(p <.000)。提出残疾索赔的11%(43/392)难民RHS-15呈阳性的可能性高出5.1倍(比值比4.3,95%置信区间2.1 - 8.8)。RHS-15呈阳性并不能预测残疾索赔(阳性预测值19%),而RHS-15呈阴性的难民不太可能提出残疾索赔(阴性预测值96%)。RHS-15得分与就诊利用情况相关。阳性得分不能预测后续的残疾索赔。

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