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澳大利亚急诊部门就诊的原住民和托雷斯海峡岛民的特征。

Characteristics of Aboriginal and Torres Strait Islander peoples attending Australian emergency departments.

机构信息

Policy and Research Division, Department of Policy and Strategic Partnerships, Australasian College for Emergency Medicine, Melbourne, Victoria, Australia.

Department of Emergency Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

出版信息

Emerg Med Australas. 2021 Aug;33(4):672-678. doi: 10.1111/1742-6723.13701. Epub 2020 Dec 22.

Abstract

OBJECTIVE

Aboriginal and Torres Strait Islander patients are overrepresented in Australian EDs. The present study aimed to assess their characteristics in utilising ED services at a national level.

METHODS

This exploratory, quantitative study used 2016-2017 de-identified data from the National Non-admitted Patient Emergency Department Care Database to assess the proportions (with 95% confidence interval) of Indigenous and non-Indigenous Australians across various aspects of ED presentations, including mode of arrival, triage scale, diagnosis information, episode end status and ED length of stay. Episode level ED data were compared by Indigenous status and geographical remoteness of EDs.

RESULTS

Of 7.4 million presentations, 6.58% were Indigenous presentations, with over two-thirds occurring in regional and remote EDs. Indigenous patients were more likely than non-Indigenous patients to arrive to EDs by ambulance and police/correctional services vehicle across all remoteness areas. Additionally, they were more likely to present with respiratory system illness, illness of the skin/subcutaneous tissue/breast and mental/behavioural disorders. Indigenous Australians were more likely to leave EDs before being seen or care complete (odds ratio 1.73, 95% confidence interval 1.71-1.74), and this was observed for patients classified across all levels of triage scale.

CONCLUSIONS

This is the first national study looking at the characteristics of and reasons for presenting to Australian EDs for Indigenous and non-Indigenous patients. Our findings provide important insight into the potential factors affecting Indigenous patient care, and an impetus for ongoing research and advocacy work to improve the quality of emergency care provided to Indigenous Australians.

摘要

目的

澳大利亚急诊部(ED)中,原住民和托雷斯海峡岛民患者的数量过多。本研究旨在评估全国范围内该人群利用 ED 服务的特点。

方法

本研究采用探索性、定量方法,使用 2016-2017 年国家非住院患者 ED 护理数据库的匿名数据,评估了 ED 就诊时,原住民和非原住民澳大利亚人在不同方面的比例(95%置信区间),包括到达方式、分诊级别、诊断信息、就诊结束状态和 ED 住院时间。对 ED 地理位置偏远程度不同的原住民和非原住民就诊数据进行比较。

结果

在 740 万例就诊中,有 6.58%为原住民就诊,其中超过三分之二发生在地区和偏远 ED。与非原住民患者相比,所有偏远地区的原住民患者更有可能通过救护车和警察/惩教服务车辆到达 ED。此外,他们更有可能因呼吸系统疾病、皮肤/皮下组织/乳房疾病和精神/行为障碍就诊。原住民患者在接受治疗或完成护理前离开 ED 的可能性高于非原住民患者(比值比 1.73,95%置信区间 1.71-1.74),这一现象在所有分诊级别患者中均存在。

结论

这是第一项研究澳大利亚原住民和非原住民患者到 ED 就诊特征和原因的全国性研究。我们的研究结果为影响原住民患者护理的潜在因素提供了重要的见解,并为持续开展研究和倡导工作以改善向原住民澳大利亚人提供的紧急护理质量提供了动力。

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