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用法属圭亚那国家健康数据系统分析老年人潜在可避免住院情况及其相关因素。

Potentially avoidable hospitalizations and associated factors among older people in French Guiana using the French National Health Data System.

机构信息

Medicine Department, Université Paul Sabatier Toulouse 3, 37 Allées Jules Guesde, Toulouse 31000, France.

Observatoire Régional de la Santé de Guyane, 771 route de Baduel, Cayenne 97300, French Guiana.

出版信息

Int J Qual Health Care. 2024 Sep 3;36(3). doi: 10.1093/intqhc/mzae083.

Abstract

Knowing the prevalence of potentially avoidable hospitalizations (PAHs) and the factors associated with them is essential if preventive action is to be taken. Studies on PAHs mainly concern adults, and very few have been carried out in South America. To the best of our knowledge, there has been no study on PAHs in French Guiana, particularly among older adults. This case-control study aimed to estimate the prevalence of PAHs in the Guianese population aged over 65 and to analyze their associated factors. We used the 2017-2019 data from the French National Health Service database (Système National des Données de Santé). The patients were age- and sex-matched 1 : 3 with controls without any PAH in 2019. Factors associated with PAHs were investigated through two conditional logistic regression models [one including the Charlson comorbidity index (CCI) and one including each comorbidity of the CCI], with calculation of the adjusted odds ratio (aOR) and 95% confidence interval (CI). The PAH incidence was 17.4 per 1000 inhabitants. PAHs represented 6.6% of all hospitalizations (45.6% related to congestive heart failure or hypertension). A higher CCI was associated with PAHs [aOR 2.2 (95% CI: 1.6, 3.0) and aOR 4.8 (95% CI: 2.4, 9.9) for 1-2 and ≥3 comorbidities, respectively, versus 0], as was immigrant health insurance status [aOR 2.3 (95% CI: 1.3, 4.2)]. Connective tissue disease, chronic pulmonary disease, congestive heart failure, diabetes, and peripheral vascular disease were comorbidities associated with an increased risk of PAHs. While the prevention of PAHs among immigrants is probably beyond the reach of the Guianese authorities, primary care and a public health policy geared toward prevention should be put in place for the French Guianese population suffering from cardiovascular disease in order to reduce PAHs.

摘要

了解可避免住院治疗(PAHs)的流行情况以及与之相关的因素至关重要,因为只有这样才能采取预防措施。关于 PAHs 的研究主要针对成年人,而在南美洲进行的研究非常少。据我们所知,在法属圭亚那,特别是在老年人中,还没有关于 PAHs 的研究。本病例对照研究旨在估计法属圭亚那 65 岁以上人群中 PAHs 的流行情况,并分析其相关因素。我们使用了 2017 年至 2019 年法国国家卫生服务数据库(Système National des Données de Santé)的数据。在 2019 年,将每 1 名患有 PAHs 的患者与年龄和性别相匹配的 3 名无 PAHs 的对照者进行匹配。通过两个条件逻辑回归模型(一个包含 Charlson 合并症指数(CCI),另一个包含 CCI 的每个合并症)来研究与 PAHs 相关的因素,计算调整后的优势比(aOR)和 95%置信区间(CI)。PAH 的发病率为每 1000 居民 17.4 例。PAHs 占所有住院治疗的 6.6%(45.6%与充血性心力衰竭或高血压有关)。CCI 较高与 PAHs 相关(CCI 为 1-2 种和≥3 种疾病时,aOR 分别为 2.2(95%CI:1.6,3.0)和 4.8(95%CI:2.4,9.9),而 0 为参照),移民健康保险状况也是如此[aOR 2.3(95%CI:1.3,4.2)]。结缔组织疾病、慢性肺部疾病、充血性心力衰竭、糖尿病和外周血管疾病是与 PAHs 风险增加相关的合并症。尽管预防移民中的 PAHs 可能超出了法属圭亚那当局的能力范围,但应针对患有心血管疾病的法属圭亚那人群制定初级保健和公共卫生政策,以减少 PAHs。

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