Lin Sue C, Chang Kimberly S G, Marjavi Anna, Chon Katherine Y, Dichter Melissa E, DuBois Palardy Jessica
Bureau of Primary Health Care Office of Quality Improvement, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, MD, USA.
Asian Health Services, Oakland, CA, USA.
Public Health Rep. 2025 Jan-Feb;140(1_suppl):82S-89S. doi: 10.1177/00333549241239886. Epub 2024 Apr 1.
The Health Resources and Services Administration (HRSA) began collecting data on intimate partner violence (IPV) and human trafficking (HT) in the 2020 Uniform Data System (UDS). We examined patients affected by IPV and HT served by HRSA-funded health centers in medically underserved US communities during the COVID-19 pandemic.
We established a baseline and measured trends in patient care by analyzing data from the 2020 (N = 28 590 897) and 2021 (N = 30 193 278) UDS. We conducted longitudinal ordinal logistic regression analyses to assess the association of care trends and organization-level and patient characteristics using proportional odds ratios (PORs) and 95% CIs.
The number of clinical visits for patients affected by IPV and HT decreased by 29.4% and 88.3%, respectively, from 2020 to 2021. Health centers serving a higher (vs lower) percentage of pediatric patients were more likely to continuously serve patients affected by IPV (POR = 2.58; 95% CI, 1.01-6.61) and HT (POR = 6.14; 95% CI, 2.06-18.29). Health centers serving (vs not serving) patients affected by IPV were associated with a higher percentage of patients who had limited English proficiency (POR = 1.77; 95% CI, 1.02-3.05) and Medicaid beneficiaries (POR = 2.88; 95% CI, 1.48-5.62), whereas health centers serving (vs not serving) patients affected by HT were associated with a higher percentage of female patients of reproductive age (POR = 15.89; 95% CI, 1.61-157.38) and urban settings (POR = 1.74; 95% CI, 1.26-2.37).
The number of clinical visits for patients affected by IPV and HT during the COVID-19 pandemic declined. Delayed care will pose challenges for future health care needs of these populations.
美国卫生资源与服务管理局（HRSA）于2020年开始在统一数据系统（UDS）中收集亲密伴侣暴力（IPV）和人口贩运（HT）的数据。我们调查了在新冠疫情期间，由HRSA资助的美国医疗服务不足社区的医疗中心所服务的受IPV和HT影响的患者。
我们通过分析2020年（N = 28590897）和2021年（N = 30193278）UDS的数据，建立了基线并测量了患者护理的趋势。我们进行了纵向有序逻辑回归分析，以使用比例优势比（POR）和95%置信区间（CI）评估护理趋势与机构层面及患者特征之间的关联。
从2020年到2021年，受IPV和HT影响的患者的临床就诊次数分别下降了29.4%和88.3%。服务儿科患者比例较高（相对于较低）的医疗中心更有可能持续为受IPV影响的患者（POR = 2.58；95% CI，1.01 - 6.61）和受HT影响的患者（POR = 6.14；95% CI，2.06 - 18.29）提供服务。服务（相对于不服务）受IPV影响患者的医疗中心，其英语水平有限的患者比例（POR = 1.77；95% CI，1.02 - 3.05）和医疗补助受益人的比例（POR = 2.88；95% CI，1.48 - 5.62）较高，而服务（相对于不服务）受HT影响患者的医疗中心，其育龄期女性患者比例（POR = 15.89；95% CI，1.61 - 157.38）和城市地区患者比例（POR = 1.74；95% CI，1.26 - 2.37）较高。
新冠疫情期间，受IPV和HT影响的患者的临床就诊次数有所下降。护理延迟将给这些人群未来的医疗需求带来挑战。
