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为有复杂健康需求的移民提供有针对性的医疗保健服务。

Providing targeted healthcare services for immigrants with complex health needs.

出版信息

Dan Med J. 2020 Sep 7;67(10):A03190160.

Abstract

INTRODUCTION

Providing targeted healthcare for immigrants with complex needs is an innovative approach to reducing health inequities. This study explores sociodemographic characteristics, symptoms and morbidity patterns of patients attending one such pioneering clinic.

METHODS

This was a cross-sectional survey based on 408 patients seen from 1 January 2014 to 20 November 2017. Data on socio-demographics, referral patterns, migration background, symptoms and multimorbidity were collected using a standardised screening questionnaire. Baseline blood test results were included for a subpopulation (n = 178). Data were analysed using descriptive statistics and logistic regression analysis.

RESULTS

The patients, among whom 83% (n = 334) were women, represented 43 nationalities and had a mean age of 49 years. A total of 19% (n = 78) had no formal schooling. More than 70% (n = 287) reported an (oral and written) interpreter need despite most (63%) having resided in Denmark for > 20 years. Reported symptoms were often pain-related, and 87% (n = 355) reported ≥ 5 symptoms. Multi-morbidity (≥ 2 reported diagnoses) was seen in 73% (n = 298) of the patients. Women had a significantly lower odds ratio (OR) of having > 5 symptoms (OR = 0.44; 95% confidence interval (CI): 0.21-0.92) and an insignificantly lower risk of multi-morbidity (OR = 0.76; 95% CI: 0.40-1.43) than men; no significant differences were seen according to migrant status.

CONCLUSIONS

The patients presented with a complex disease burden, language and a disadvantaged socioeconomic status highlighting the need for targeted health services for vulnerable immigrant groups in order to reduce inequities in health.

FUNDING

Department of Infectious Diseases, Hvidovre Hospital.

TRIAL REGISTRATION

none.

摘要

简介

为有复杂需求的移民提供针对性医疗保健是减少健康不平等的一种创新方法。本研究探讨了一家此类开创性诊所就诊患者的社会人口统计学特征、症状和发病模式。

方法

这是一项基于 2014 年 1 月 1 日至 2017 年 11 月 20 日期间就诊的 408 名患者的横断面调查。使用标准化筛查问卷收集社会人口统计学、转诊模式、移民背景、症状和多种疾病的数据。为亚人群(n=178)纳入了基线血液检测结果。使用描述性统计和逻辑回归分析进行数据分析。

结果

患者中,83%(n=334)为女性,代表 43 个国籍,平均年龄为 49 岁。19%(n=78)没有正规教育。尽管大多数(63%)患者在丹麦居住超过 20 年,但超过 70%(n=287)报告有(口头和书面)翻译需求。报告的症状通常与疼痛有关,87%(n=355)报告有≥5 种症状。73%(n=298)的患者患有多种疾病(≥2 种诊断)。女性出现≥5 种症状的可能性显著降低(OR=0.44;95%置信区间[CI]:0.21-0.92),且多种疾病的风险显著降低(OR=0.76;95%CI:0.40-1.43),而男性则没有显著差异;根据移民身份,没有发现显著差异。

结论

患者呈现出复杂的疾病负担、语言和不利的社会经济地位,这突出表明需要为弱势移民群体提供有针对性的卫生服务,以减少健康方面的不平等。

资金

Hvidovre 医院传染病科。

试验注册

无。

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