2015-19 年初级保健短缺地区的急诊手术、严重并发症和再入院率较高。

IF 8.6 1区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Sara L Schaefer, Shukri H A Dualeh, Nicholas Kunnath, John W Scott, Andrew M Ibrahim
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引用次数: 0

摘要

初级保健医生往往最先筛查和识别出患有对就医机会敏感的外科疾病的病人,这些病人应接受择期治疗。这些病症需要的手术最好是有计划的(选择性)手术,但在就医途径有限的情况下,治疗可能会被延误,症状恶化导致急诊手术(例如,癌症结肠切除术、腹主动脉瘤修补术和切口疝修补术)。我们评估了 2015-19 年间居住在初级医疗保健专业人员短缺地区的三种对就医敏感的手术患者的择期手术率与急诊手术率。与最不严重的短缺地区相比(37.8% 对 29.9%),更严重的初级保健短缺地区的医疗保险受益人接受急诊手术的比例更高。他们也更有可能出现严重并发症(14.9% 对 11.7%)和再入院(15.7% 对 13.5%)。当我们考虑到外科医生短缺的地区时,结果与此类似。综上所述,这些研究结果表明,初级保健人员更加短缺地区的居民在获得选择性外科护理方面也可能面临挑战。在政策制定者考虑对医疗专业人员短缺地区进行投资时,我们的研究结果强调了初级医疗获得更广泛服务的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Higher Rates Of Emergency Surgery, Serious Complications, And Readmissions In Primary Care Shortage Areas, 2015-19.

Primary care physicians are often the first to screen and identify patients with access-sensitive surgical conditions that should be treated electively. These conditions require surgery that is preferably planned (elective), but, when access is limited, treatment may be delayed and worsening symptoms lead to emergency surgery (for example, colectomy for cancer, abdominal aortic aneurysm repair, and incisional hernia repair). We evaluated the rates of elective versus emergency surgery for patients with three access-sensitive surgical conditions living in primary care Health Professional Shortage Areas during 2015-19. Medicare beneficiaries in more severe primary care shortage areas had higher rates of emergency surgery compared with rates in the least severe shortage areas (37.8 percent versus 29.9 percent). They were also more likely to have serious complications (14.9 percent versus 11.7 percent) and readmissions (15.7 percent versus 13.5 percent). When we accounted for areas with a shortage of surgeons, the findings were similar. Taken together, these findings suggest that residents of areas with greater primary care workforce shortages may also face challenges in accessing elective surgical care. As policy makers consider investing in Health Professional Shortage Areas, our findings underscore the importance of primary care access to a broader range of services.

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来源期刊
Health Affairs
Health Affairs 医学-卫生保健
CiteScore
15.00
自引率
2.10%
发文量
246
审稿时长
3-6 weeks
期刊介绍: Health Affairs is a prestigious journal that aims to thoroughly examine significant health policy matters both domestically and globally. Our publication is committed to addressing issues that are relevant to both the private and public sectors. We are enthusiastic about inviting private and public decision-makers to contribute their innovative ideas in a publishable format. Health Affairs seeks to incorporate various perspectives from industry, labor, government, and academia, ensuring that our readers benefit from the diverse viewpoints within the healthcare field.
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