Bennett Christopher L, Clay Carson E, Espinola Janice A, Camargo Carlos A
Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Public Health Rep. 2024 Nov 7:333549241288374. doi: 10.1177/00333549241288374.
Despite serving populations emphasized in the Ending the HIV Epidemic Initiative, emergency departments (EDs) infrequently offer routine HIV screening. The objective of this study was to characterize US EDs by whether they screen for HIV and to explore factors associated with screening. We surveyed a random sample of US ED directors to obtain data on ED-level and patient-level characteristics, as well as information on directors' perceived barriers to implementing preventive health services. Using descriptive statistics and regression modeling, we found that EDs that routinely screen for HIV, compared with those that do not, had higher median visit volumes (21 000 vs 12 600), were more often a teaching hospital (12.7% vs 4.3%), and had more availability of social workers (23.6% vs 9.4% had 24 hour/day coverage); their directors also less often expressed strong worry about costs (5.9% vs 28.2%), all significant at < .05; in the regression analysis, only worry about costs was significant (relative risk = 0.13; 95% CI, 0.03-0.51). Our findings may reflect a need for additional funding and resources allocated to EDs to promote HIV screening.
尽管在“终结艾滋病流行倡议”中强调了服务对象，但急诊科很少提供常规的艾滋病毒筛查。本研究的目的是根据美国急诊科是否进行艾滋病毒筛查来对其进行特征描述，并探索与筛查相关的因素。我们对美国急诊科主任进行了随机抽样调查，以获取有关急诊科层面和患者层面特征的数据，以及有关主任们认为实施预防性健康服务的障碍的信息。通过描述性统计和回归模型，我们发现，与不进行常规艾滋病毒筛查的急诊科相比，进行常规筛查的急诊科就诊量中位数更高（21000人次对12600人次），更常为教学医院（12.7%对4.3%），且有更多的社会工作者（24小时/天提供服务的比例为23.6%对9.4%）；其主任对成本强烈担忧的情况也较少（5.9%对28.2%），所有这些差异均在<0.05水平上具有统计学意义；在回归分析中，只有对成本的担忧具有统计学意义（相对风险=0.13；95%置信区间，0.03 - 0.51）。我们的研究结果可能反映出需要为急诊科分配更多资金和资源以促进艾滋病毒筛查。
