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难民人群中的常见诊断:与全州医院出院数据库的关联结果。

Common Diagnoses among Refugee Populations: Linked Results with Statewide Hospital Discharge Database.

机构信息

Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE 68198-4395, US.

Division of Public Health, Nebraska Department of Health and Human Services, 301 Centennial Mall South, Lincoln, NE 68509-5026, US.

出版信息

Ann Glob Health. 2018 Oct 10;84(3):541-550. doi: 10.29024/aogh.2354.

Abstract

BACKGROUND

According to the U.S. State Department's Refugee Processing Center and the U.S. Census Bureau, in the fiscal year 2016, among all states in the United States, Nebraska resettled the highest number of refugees per capita.

OBJECTIVES

The objectives of this study were to determine the most common reasons for refugees utilizing hospital services in Nebraska between January 2011 and September 2015, and to examine whether refugee patients had increased risks for adverse health conditions compared to non-refugee patients.

METHODS

Statewide linkage was performed between Nebraska Medicaid Program's immigration data, and 2011-2015 Nebraska hospital discharge data inpatient and outpatient files. The linkage produced 3017, 5460, and 775 cases for emergency department visits, outpatient clinic visits, and inpatient care for the refugee sample, respectively.

FINDINGS

Refugee patients were at increased risk for a number of diagnoses or medical conditions, including pregnancy complications, abdominal pain, upper respiratory infections, viral infections, mood disorders, disorders of teeth and jaw, deficiency and anemia, urinary system disorders, headache, nausea and vomiting, limb fractures, spondylosis, essential hypertension, and uncomplicated diabetes mellitus.

CONCLUSIONS

The findings suggest a greater emphasis on preventive healthcare, especially in areas of maternal health and perinatal outcomes, psychological counseling, screening for infectious diseases, nutrition and healthy eating, and oral health. Additionally, culturally appropriate measures to address prevention, health screening, and treatments should be adopted by health providers who care for refugees.

摘要

背景

根据美国国务院难民事务处理中心和美国人口普查局的数据,在 2016 财年,在美国所有州中,内布拉斯加州每人均安置的难民数量最多。

目的

本研究旨在确定 2011 年 1 月至 2015 年 9 月期间内布拉斯加州难民利用医院服务的最常见原因,并考察与非难民患者相比,难民患者的健康状况不良风险是否增加。

方法

在内布拉斯加州医疗补助计划的移民数据与 2011-2015 年内布拉斯加州医院出院数据的住院和门诊档案之间进行了全州范围的链接。该链接分别为急诊就诊、门诊就诊和住院治疗的难民样本生成了 3017、5460 和 775 例。

结果

难民患者存在多种诊断或医疗状况的风险增加,包括妊娠并发症、腹痛、上呼吸道感染、病毒感染、情绪障碍、牙齿和颌骨疾病、缺乏症和贫血、泌尿系统疾病、头痛、恶心和呕吐、四肢骨折、颈椎病、原发性高血压和单纯性糖尿病。

结论

这些发现表明应更加重视预防保健,特别是在孕产妇健康和围产期结局、心理咨询、传染病筛查、营养和健康饮食以及口腔健康等领域。此外,为照顾难民的医疗服务提供者应采取针对预防、健康筛查和治疗的文化适宜措施。

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