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产妇信心与婴儿急诊利用率

Maternal Confidence and Emergency Department Utilization Among Infants.

机构信息

From the Department of Pediatrics, Inova Children's Hospital.

Inova Translational Medicine Institute (ITMI), Inova Health Systems, Falls Church.

出版信息

Pediatr Emerg Care. 2021 May 1;37(5):260-264. doi: 10.1097/PEC.0000000000002419.

Abstract

OBJECTIVES

To determine if maternal confidence affects emergency department (ED) utilization in the first year of life.

METHODS

This retrospective cohort study examined the Maternal Confidence Questionnaire responses from a longitudinal birth cohort study and ED visits for these subjects across all Inova hospitals from January 2012 to July 2017 for full-term children 12 months or younger at the time of visit. Using logistic regression, maternal confidence, maternal race/ethnicity, age, education, parity, and insurance were evaluated against Emergency Severity Index acuity levels and ED visit frequency.

RESULTS

Of 2429 participants in the longitudinal study, 316 subjects visited the ED and met inclusion criteria. Medicaid status was the main factor associated with any ED visit. Low maternal confidence did not correlate with more frequent or nonurgent ED visits. Higher maternal confidence scores were seen in Hispanic or Latino mothers and mothers with parity greater than 1. Hispanic or Latino mothers were more likely to have Medicaid and more likely to bring their child to the ED. Mothers with college education had lower maternal confidence scores, were less likely to visit the ED, but had higher acuity level visits.

CONCLUSIONS

Low maternal confidence did not correlate with frequent ED visits or nonurgent visits. Medicaid status was the main factor associated with any ED visit. Hispanic or Latino mothers had higher maternal confidence scores, were more likely to have Medicaid and more likely to bring their child to the ED.

摘要

目的

确定产妇信心是否会影响婴儿出生后第一年的急诊就诊率。

方法

本回顾性队列研究对来自纵向出生队列研究的产妇信心问卷的回答进行了分析,并对 2012 年 1 月至 2017 年 7 月期间所有因 12 个月或更小的足月儿童就诊而在 Inova 医院就诊的受试者进行了 ED 就诊情况的分析。采用逻辑回归分析,评估产妇信心、产妇种族/民族、年龄、教育程度、产次和保险等因素与紧急严重程度指数(ESI)严重程度分级和 ED 就诊频率的关系。

结果

在 2429 名参加纵向研究的参与者中,有 316 名受试者到 ED 就诊并符合纳入标准。医疗补助(Medicaid)状态是与任何 ED 就诊相关的主要因素。低产妇信心与更频繁或非紧急 ED 就诊无关。西班牙裔或拉丁裔母亲和多胎次母亲的产妇信心得分较高。西班牙裔或拉丁裔母亲更有可能获得医疗补助,更有可能带孩子去 ED。具有大学学历的母亲的产妇信心评分较低,去 ED 的可能性较低,但就诊时的严重程度较高。

结论

低产妇信心与频繁的 ED 就诊或非紧急就诊无关。医疗补助状态是与任何 ED 就诊相关的主要因素。西班牙裔或拉丁裔母亲的产妇信心得分较高,更有可能获得医疗补助,更有可能带孩子去 ED。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78d0/8083161/80c26dce0f95/pcare-37-260-g001.jpg

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