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创伤中心人际暴力受害者医疗服务使用的恢复服务。

Recovery Services for Interpersonal Violence Victims on Healthcare Use at a Trauma Center.

机构信息

MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.

MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio.

出版信息

J Surg Res. 2024 Jan;293:443-450. doi: 10.1016/j.jss.2023.08.037. Epub 2023 Oct 9.

Abstract

INTRODUCTION

Treatment of interpersonal violence (IPV) patients is often complicated by social and mental health comorbidities. New American College of Surgeons (ACS) requirements include provision of psychosocial support services for recovery after injury. We aim to describe utilization and patient outcomes after provision of Trauma Recovery Services (TRS) at our institution for the IPV population. These services include assistance with food, housing, criminal justice, and advocacy.

METHODS

IPV patients were identified between September 6, 2018 and December 20, 2020. Demographic information was collected. TRS utilization and specific services rendered were identified. Primary outcome measures included initial length of stay (LOS), number of subsequent emergency department (ED) visits, and outpatient visits within 1 y after the initial injury. Statistical analyses included t-tests, Chi-squared tests, and multivariate regression analyses.

RESULTS

A total of 502 patients were included in the final cohort, and 394 patients (78.5%) accepted the utilization of TRS services after initial interaction. Patients were on average 33.4 y old, and 59.4% were females. Patients who were older (P < 0.001) and homeless (P = 0.004) were more likely to use TRS, while victims of sexual assault (P < 0.001) and single patients (P = 0.041) were less likely. Patients who utilized TRS had longer initial LOS (P < 0.001), more ED visits (P < 0.001), and more outpatient visits (P = 0.01) related to the initial complaint, independent of potential confounders on multivariate linear regression. Food and housing service utilization associated with LOS (P = 0.01), ED visits (P < 0.001), and outpatient visits (P < 0.001). Additionally, transportation services were associated with longer LOS (P = 0.01) while patient advocacy services were associated with more ED visits (P = 0.03).

CONCLUSIONS

TRS was extensively utilized by IPV patients, and associated with more follow-up appointments, ED visits, and longer LOS. Emphasis on injury mechanisms, baseline demographics, and social features may further characterize patients in need who tend toward utilization.

摘要

简介

治疗人际暴力(IPV)患者通常会因社会和心理健康合并症而变得复杂。新的美国外科医师学院(ACS)要求包括在受伤后提供康复的社会心理支持服务。我们旨在描述我们机构为 IPV 人群提供创伤恢复服务(TRS)后的利用情况和患者结局。这些服务包括帮助解决食物、住房、刑事司法和宣传问题。

方法

在 2018 年 9 月 6 日至 2020 年 12 月 20 日期间,确定了 IPV 患者。收集了人口统计学信息。确定了 TRS 的利用情况和提供的具体服务。主要结局指标包括初始住院时间(LOS)、随后急诊部(ED)就诊次数以及初始损伤后 1 年内的门诊就诊次数。统计分析包括 t 检验、卡方检验和多变量回归分析。

结果

共有 502 名患者纳入最终队列,394 名患者(78.5%)在初次接触后接受了 TRS 服务的利用。患者平均年龄为 33.4 岁,59.4%为女性。年龄较大的患者(P<0.001)和无家可归的患者(P=0.004)更有可能使用 TRS,而性侵犯受害者(P<0.001)和单身患者(P=0.041)则不太可能使用 TRS。使用 TRS 的患者初始 LOS 时间更长(P<0.001)、ED 就诊次数更多(P<0.001)、与初始投诉相关的门诊就诊次数更多(P=0.01),独立于多变量线性回归中的潜在混杂因素。食物和住房服务的利用与 LOS(P=0.01)、ED 就诊次数(P<0.001)和门诊就诊次数(P<0.001)相关。此外,交通服务与 LOS 时间延长相关(P=0.01),而患者宣传服务与 ED 就诊次数增加相关(P=0.03)。

结论

TRS 被 IPV 患者广泛利用,与更多的随访预约、ED 就诊次数和更长的 LOS 时间相关。强调伤害机制、基线人口统计学和社会特征可能会进一步描述倾向于利用的患者。

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