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初级保健在青少年住院期间的性健康使用和评估。

Primary Care Use and Assessment of Adolescents' Sexual Health During Hospitalization.

机构信息

Brody School of Medicine, East Carolina University, Greenville, North Carolina

Department of Pediatrics.

出版信息

Hosp Pediatr. 2020 Nov;10(11):963-968. doi: 10.1542/hpeds.2020-0050. Epub 2020 Oct 16.

Abstract

OBJECTIVES

Hospitalization provides an opportunity to address sexual health needs of adolescents who may not otherwise receive regular medical care. We investigated documentation of a sexual health discussion with adolescents hospitalized at our medical center to determine if previous primary care physician (PCP) visits in the same health system were associated with sexual health documentation during the hospital admission.

METHODS

We retrospectively identified adolescents aged 13 to 17 years discharged from the pediatric general ward. Documented discussion of sexual health was reviewed in the electronic medical record. Previous PCP visits were identified from the affiliated primary care clinics within 12 months before hospitalization. We also queried follow-up PCP visits within 90 days of discharge to determine if a sexual health discussion during hospitalization was followed-up in the outpatient setting.

RESULTS

We analyzed 394 patients (49% girls; median age 15 years), of whom 122 (31%) had documentation of a sexual health discussion while hospitalized and 75 (19%) had previous PCP visits in our health system. On multivariable analysis, older age ( < .001), female sex ( = .016), admission from the emergency department ( < .001), and a genitourinary primary problem at admission ( = .007), but not previous PCP visits, were associated with increased likelihood of sexual health documentation.

CONCLUSIONS

Although discussion of sexual health was uncommon overall for hospitalized adolescents, we noted that nearly 4 in 5 adolescents for whom this was documented had not recently visited a PCP in our health system. These findings highlight hospitalization as a unique opportunity for sexual health intervention among adolescents who may not regularly see a PCP.

摘要

目的

住院为那些可能无法定期获得医疗护理的青少年提供了一个解决性健康需求的机会。我们调查了在我们医疗中心住院的青少年的性健康讨论记录,以确定他们在同一医疗系统中的先前初级保健医生 (PCP) 就诊是否与住院期间的性健康记录有关。

方法

我们回顾性地确定了从儿科普通病房出院的 13 至 17 岁青少年。在电子病历中查看了性健康讨论的记录。将之前的 PCP 就诊记录从住院前 12 个月内的附属初级保健诊所中识别出来。我们还查询了出院后 90 天内的后续 PCP 就诊情况,以确定在住院期间进行的性健康讨论是否在门诊随访中进行。

结果

我们分析了 394 名患者(49%为女孩;中位数年龄为 15 岁),其中 122 名(31%)在住院期间有性健康讨论的记录,75 名(19%)在我们的医疗系统中有之前的 PCP 就诊记录。在多变量分析中,年龄较大(<.001)、女性(=.016)、从急诊室入院(<.001)和入院时的泌尿生殖系统原发性问题(=.007),但不是之前的 PCP 就诊,与增加性健康记录的可能性相关。

结论

尽管总体而言,住院青少年的性健康讨论并不常见,但我们注意到,在有记录的近 4/5 的青少年中,他们最近没有在我们的医疗系统中看过 PCP。这些发现强调了住院是一个独特的机会,可以对那些可能不经常看 PCP 的青少年进行性健康干预。

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