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感染预防和控制措施对 COVID-19 大流行期间中国医患暴力侵害卫生工作者的影响。

Effects of infection prevention and control measures on patient and visitor violence against health workers in China during COVID-19 pandemic.

机构信息

Xuzhou Infectious Diseases Hospital, Xuzhou, Jiangsu, China.

Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Front Public Health. 2023 Jun 5;11:1140561. doi: 10.3389/fpubh.2023.1140561. eCollection 2023.

Abstract

OBJECTIVE

To examine trends in patient and visitor violence (PVV) among large public hospitals from 2016 to 2020 in China, and investigate the effects of infection prevention and control (IPC) measures on PVV during the COVID-19 pandemic.

METHODS

The hospital-level data of PVV used in this study from 2016 to 2020 in three cities in northern China were extracted from the database of the Medical Quality and Safety Notification System from 41 public hospitals. The difference-in-difference (DID) method was used to estimate the effects of IPC measures on PVV. The empirical strategy was to compare changes in the incidence rate of PVV in public hospitals where IPC measures were stricter to relatively weaker hospitals.

RESULTS

From 2019 to 2020, the incidence rate of PVV decreases from 4.59 to 2.15% for high-IPC measure level hospitals and increases from 4.42 to 4.56% for medium-IPC measure level hospitals. The results from the DID models showed that as the IPC measure level increased, the incidence rate of PVV ( = -3.12, 95% CI = -5.74 ~ -0.50) decreased more significantly based on controlling for hospital fixed effects and time trends.

CONCLUSION

The multi-dimensional and comprehensive IPC measures throughout the pandemic in China have not only controlled the pandemic, but also directly or indirectly reduced the incidence rate of PVV by alleviating the stress of health workers and the crowded working environment, creating a good order of admission, and reducing patient waiting time.

摘要

目的

探讨 2016 年至 2020 年期间中国大型公立医院患者和访客暴力(PVV)的趋势,并研究 COVID-19 大流行期间感染预防和控制(IPC)措施对 PVV 的影响。

方法

本研究从中国北方三个城市的 41 家公立医院的医疗质量和安全通知系统数据库中提取了 2016 年至 2020 年期间医院层面的 PVV 数据。采用差分法(DID)来估计 IPC 措施对 PVV 的影响。实证策略是比较 IPC 措施较严格的公立医院和相对较弱的公立医院的 PVV 发生率的变化。

结果

2019 年至 2020 年,IPC 措施水平较高的医院的 PVV 发生率从 4.59%降至 2.15%,IPC 措施水平中等的医院的 PVV 发生率从 4.42%升至 4.56%。DID 模型的结果表明,随着 IPC 措施水平的提高,PVV 的发生率( = -3.12,95%CI = -5.74 ~ -0.50)下降得更为显著,这是在控制医院固定效应和时间趋势的基础上得出的。

结论

中国在整个大流行期间采取的多维和综合的 IPC 措施不仅控制了疫情,而且还通过缓解医护人员的压力和拥挤的工作环境、创造良好的入院秩序和减少患者等待时间,直接或间接地降低了 PVV 的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67d7/10277554/399a39e116f1/fpubh-11-1140561-g001.jpg

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