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急诊患者中偏好非英语语言者的健康状况和医疗保健利用模式。

Health Status and Healthcare Utilization Patterns of Emergency Department Patients Who Prefer a Language Other Than English.

机构信息

Emory University School of Medicine, Atlanta, GA, 30322, USA.

Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.

出版信息

J Immigr Minor Health. 2024 Dec;26(6):959-965. doi: 10.1007/s10903-024-01623-4. Epub 2024 Jul 31.

DOI:10.1007/s10903-024-01623-4
PMID:39083242
Abstract

Immigrants, nearly half of whom prefer a language other than English (LOE), face structural barriers to healthcare. This subgroup is believed to be at increased risk for reduced access to quality healthcare, yet few studies have examined the health needs and utilization patterns of LOE-preferring patients who seek care in the Emergency Department (ED). Given that the ED is often an entry point to the health system, we sought to characterize the health patterns of this population in an urban ED setting. We conducted a retrospective chart review of the electronic medical records of 1,566 patients who utilized interpreter services in the ED or Urgent Care) at an urban safety net hospital. We found that LOE-preferring patients had high levels of chronic disease. We also found that the majority of these patients had not seen a primary care provider (PCP) within the study period. PCP visits were positively associated with ED utilization suggesting that those without a PCP are less likely to receive ED care. These findings point to a need for greater policy and community health solutions addressing the high burden of chronic disease and underutilization of healthcare for those with LOE preferences.

摘要

移民群体中,近一半人更喜欢使用英语以外的语言(LOE),他们在获得医疗保健方面面临着结构性障碍。这一亚群被认为面临着获得高质量医疗保健的机会减少的风险,但很少有研究调查过在急诊部(ED)寻求医疗护理的偏爱 LOE 的患者的健康需求和利用模式。鉴于 ED 通常是进入医疗系统的入口,我们试图在城市 ED 环境中描述这一人群的健康模式。我们对城市医疗保障医院急诊部或紧急护理中心使用口译服务的 1566 名患者的电子病历进行了回顾性图表审查。我们发现,偏爱 LOE 的患者患有慢性疾病的比例很高。我们还发现,这些患者中的大多数在研究期间都没有看过初级保健医生(PCP)。PCP 就诊与 ED 使用呈正相关,这表明没有 PCP 的患者不太可能接受 ED 护理。这些发现表明,需要制定更多的政策和社区卫生解决方案,以解决偏爱 LOE 的患者慢性疾病负担高和医疗保健利用不足的问题。

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本文引用的文献

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Community Health Worker Integration with and Effectiveness in Health Care and Public Health in the United States.美国社区卫生工作者融入医疗保健和公共卫生体系及其成效
Annu Rev Public Health. 2023 Apr 3;44:363-381. doi: 10.1146/annurev-publhealth-071521-031648.
2
The Effect of Primary Care Visits on Total Patient Care Cost: Evidence From the Veterans Health Administration.初级保健访视对患者总医疗费用的影响:来自退伍军人健康管理局的证据。
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221141792. doi: 10.1177/21501319221141792.
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Expanding Insurance Coverage to Undocumented Immigrants in Connecticut.
将保险覆盖范围扩大至康涅狄格州的无证移民。
Rand Health Q. 2022 Nov 14;10(1):3. eCollection 2022 Nov.
4
Impact of United States 2017 Immigration Policy changes on missed appointments at two Massachusetts Safety-Net Hospitals.2017 年美国移民政策变化对马萨诸塞州两家“安全网”医院预约失约情况的影响。
J Immigr Minor Health. 2022 Aug;24(4):807-818. doi: 10.1007/s10903-022-01341-9. Epub 2022 May 27.
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Impact of Electronic Health Records on Information Practices in Mental Health Contexts: Scoping Review.电子健康记录对心理健康环境下信息实践的影响:范围综述。
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Assessing the indirect effects of COVID-19 on healthcare delivery, utilization and health outcomes: a scoping review.评估 COVID-19 对医疗服务提供、利用和健康结果的间接影响:范围综述。
Eur J Public Health. 2021 Jul 13;31(3):634-640. doi: 10.1093/eurpub/ckab047.
7
Preventive Care and Management of Chronic Diseases in Immigrant Adults.移民成年人的慢性病预防保健和管理。
Prim Care. 2021 Mar;48(1):83-97. doi: 10.1016/j.pop.2020.09.006. Epub 2020 Dec 7.
8
Highly vulnerable communities and the Affordable Care Act: Health insurance coverage effects, 2010-2018.高度脆弱社区与平价医疗法案:2010-2018 年的医疗保险覆盖效果。
Soc Sci Med. 2021 Feb;270:113670. doi: 10.1016/j.socscimed.2021.113670. Epub 2021 Jan 6.
9
Association of Patients' Perception of Primary Care Provider Listening With Emergency Department Use.患者对初级保健提供者倾听的感知与急诊科使用情况的关联。
PRiMER. 2020 May 22;4:7. doi: 10.22454/PRiMER.2020.951748. eCollection 2020.
10
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BMC Public Health. 2020 Jan 8;20(1):27. doi: 10.1186/s12889-019-8127-9.