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有寄养史患者与无寄养史患者相比,急诊科可避免的医疗服务利用情况。

Preventable Emergency Department Utilization Among Patients With Foster Care History Compared to Patients Without Foster Care History.

作者信息

Malthaner Lauren Q, McLeigh Jill D, Knell Gregory, Jetelina Katelyn K, Atem Folefac, Messiah Sarah E

机构信息

Department of Epidemiology, UTHealth Houston School of Public Health, Dallas, TX, USA.

Center for Pediatric Population Health, UTHealth Houston School of Public Health, Dallas, TX, USA.

出版信息

Child Maltreat. 2024 Nov 25:10775595241300971. doi: 10.1177/10775595241300971.

Abstract

Emergency department (ED) utilization for preventable reasons by patients with foster care history is unexplored. Medical records of ED encounters from primary care patients were pulled from a southwestern children's hospital system. Necessity of ED encounter was categorized using the New York University- ED Algorithm into emergent, intermediate, or non-emergent. Associations were explored at the encounter- and patient-level. Partial proportional logistic models generated odds of preventable (i.e., intermediate or nonemergent) ED utilization among encounters, and Poisson models determined incidence of preventable ED use at the patient level. Findings suggested that when a patient with history in foster care used the ED, the odds that it was preventable were lower than if the child did not have such experience. Further, patients with foster care history were less likely to use the ED for concerns that did not need immediate attention but were more likely to use the ED for intermediate reasons.

摘要

寄养史患者因可预防原因而使用急诊科(ED)的情况尚未得到研究。从一家西南儿童医院系统提取了初级保健患者急诊科就诊的病历。使用纽约大学急诊科算法将急诊科就诊的必要性分为紧急、中级或非紧急。在就诊和患者层面探讨了相关性。部分比例逻辑模型生成了就诊时可预防(即中级或非紧急)急诊科使用的几率,泊松模型确定了患者层面可预防急诊科使用的发生率。研究结果表明,有寄养史的患者使用急诊科时,其可预防的几率低于没有此类经历的儿童。此外,有寄养史的患者因无需立即关注的问题而使用急诊科的可能性较小,但因中级原因使用急诊科的可能性较大。

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