与自我报告的急诊科使用率相关的社会人口变量：一项基于人口的横断面分析

IF 1.3 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-06-13 DOI:10.1016/j.jemermed.2025.05.028

Umaima Abbas MD(C) , Thanansayan Dhivagaran MD(C) , Fahad R. Butt MD(C) , Christine Wang BHSc(C) , Ante Cuvalo BHSc(C) , Varounan Dhivagaran HBSc , Erfun Hatam MD

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引用次数: 0

摘要

背景：目前的证据表明，在不同的人口和社会经济群体中，ED的使用存在差异。然而，最近缺乏证据探索多种社会人口变量的相互作用及其对急诊科（ED）利用的影响。目的探讨多种社会人口学变量对ED使用率的影响及相互作用。方法采用2023年全国健康访谈调查（NHIS）数据进行横断面、基于人群的logistic回归分析。结果女性患者使用ED的调整后几率显著高于男性(OR 1.31, 95% CI 1.21-1.41, p <；0.001)，黑人（OR 1.16, 95% CI 1.03-1.31, p = 0.014）和美洲印第安人/阿拉斯加人（OR 1.37, 95% CI 1.04-1.81, p = 0.026）。与18-25岁的个体相比，50-74岁的个体(p <；0.05)的几率较低。与5倍贫困线的参与者相比，收入为2 - 5倍贫困线、1 - 2倍贫困线和1倍贫困线的参与者占19% (p <；0.001), 40% (p <；0.001)和52% (p <；0.001)，分别增加了ED的使用几率。医疗补助/公共保险个人(OR 1.43, 95% CI 1.29-1.59, p <；0.001)和高中教育（OR 1.12, 95% CI 1.01-1.23, p = 0.025）与私人保险和大学教育相比，ED使用的几率更高。无法进入常规护理场所的患者(OR 0.71, 95% CI 0.60-0.82, p <；0.001)的几率较低。与健康状况良好的参与者相比，健康状况不佳的参与者(OR 2.03, 95% CI 1.84-2.25, p <；0.001)或差(or 4.4, 95% CI 3.77-5.24, p <；0.001)的健康状况有更高的急诊科就诊几率。结论性别、年龄、种族、收入、保险范围、教育程度、自我报告健康状况和就诊可及性是ED就诊的重要预测因素。

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Sociodemographic Variables Associated with Self-Reported Emergency Department Utilization: A Cross-Sectional, Population-Based Analysis

Background

Current evidence has established disparities in ED utilization across various demographic and socioeconomic groups. However, there is a paucity of recent evidence exploring the interaction of multiple sociodemographic variables and their influence on emergency department (ED) utilization.

Objectives

To evaluate the influence and interaction of multiple sociodemographic variables on ED utilization.

Methods

Cross-sectional, population-based logistic regression analyses were conducted using the 2023 National Health Interview Survey (NHIS) data.

Results

Adjusted odds of ED utilization were significantly higher among female (OR 1.31, 95% CI 1.21–1.41, p < 0.001), Black (OR 1.16, 95% CI 1.03–1.31, p = 0.014) and American Indian/Alaskan (OR 1.37, 95% CI 1.04–1.81, p = 0.026) individuals. Compared to ages 18-25, individuals aged 50-74 (p < 0.05) had lower odds. Compared to participants >5x poverty threshold, those with income 2–5x poverty threshold, 1–2x poverty threshold, and <1x poverty threshold had 19% (p < 0.001), 40% (p < 0.001) and 52% (p < 0.001) increased odds of ED utilization, respectively. Individuals with Medicaid/public insurance (OR 1.43, 95% CI 1.29–1.59, p < 0.001) and high school education (OR 1.12, 95% CI 1.01–1.23, p = 0.025) had higher odds of ED utilization compared to those with private insurance and college education. Those without access to a usual place of care (OR 0.71, 95% CI 0.60–0.82, p < 0.001) had lower odds. Compared to participants in good health, those in fair (OR 2.03, 95% CI 1.84–2.25, p < 0.001) or poor (OR 4.4, 95% CI 3.77–5.24, p < 0.001) health had higher odds of ED visits.

Conclusions

Sex, age, race, income, insurance coverage, education, self-reported health status and access to care are significant predictors of ED visits.

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine