Hospital Practices and Research最新文献_第9页

Transcervical Migration of an Essure® Coil 经宫颈迁移的一个Essure®线圈

Hospital Practices and Research

Pub Date : 2019-04-15 DOI: 10.15171/HPR.2019.13

T. Paterniti, L. Weber, G. Krishingner, Sarfraz Ahmad

Introduction: Essure® device malposition is a rare, but clinically significant complication, for which management is idiosyncratic. This case report describes an unusual example of Essure® migration in order to clarify reasonable management options. Case Presentation: A 50-year old G4 P2022 underwent hysteroscopic sterilization using the Essure® device. Insertion was complicated by fragmentation of both coils. Two years later, one of the coils was incidentally discovered protruding through the cervical os. The visible portion was clipped when attempts to remove the entire coil were unsuccessful. Conclusion: Difficult placement increases the risk of Essure® malposition. In asymptomatic patients, conservative management with removal of only a portion of the device is a rational approach.

简介:Essure®设备错位是一种罕见的，但临床上显著的并发症，其管理是特殊的。本案例报告描述了一个不寻常的Essure®迁移示例，以阐明合理的管理选择。病例介绍:一名50岁的G4 P2022患者使用Essure®器械行宫腔镜绝育手术。由于两个线圈的断裂，插入变得复杂。两年后，人们偶然发现其中一个线圈突出了颈o。当试图移除整个线圈不成功时，可见部分被剪断。结论:置入困难增加了Essure®错位的风险。对于无症状的患者，保守治疗仅切除部分装置是一种合理的方法。

引用次数: 0

Risk Factors for Surgical Site Infection After Appendectomy for Acute Appendicitis; Results of a Cross-Sectional Study Carried out at a Community Hospital in Qatar (2013-2016) 急性阑尾炎术后手术部位感染的危险因素分析2013-2016年卡塔尔某社区医院横断面研究结果

Hospital Practices and Research

Pub Date : 2019-04-15 DOI: 10.15171/HPR.2019.08

H. G. Garcell, A. V. Arias, C. P. Sandoval, A. B. Sado, R. N. A. Serrano, Francisco Gutiérrez García

Background: Identifying risk factors for surgical site infection (SSI) after appendectomies could be useful in focusing prevention programs. Objective: The current study aimed to identify the risk factors associated with SSI in a cohort of patients from a single center in Western Qatar. Methods: This cross-sectional study was carried out at The Cuban Hospital (Dukhan, Qatar) on patients who had undergone an appendectomy from January 2013 through September 2016. Data extracted from the patient files included demographics, comorbidities and toxic habits, surgery type, procedure duration, wound type, appendicitis-type, American Anesthesiology Score, body mass index, selected laboratory tests, and compliance with antibiotic prophylaxis. Results: The study variables, type of surgery performed, procedure duration, wound and appendicitis type, serum albumin, and timing of antibiotic prophylaxis, were found to be related to the occurrence of SSI in univariate analysis (P = 0.000). Logistic regression showed that open appendectomies (odds ratio [OR] = 22.90, 95% CI; 8.04-65.21), low serum albumin (OR = 0.92, 95% CI; 0.85-0.99), and improper timing of antibiotic prophylaxis (OR = 44.92, 95% CI; 3.39-594.91) were independently associated with the occurrence of SSI. Conclusion: Cases of complex appendicitis, open procedure, low serum albumin level, and improper timing of antibiotic prophylaxis constituted the risk factors for SSI in the setting of this study. The infection control program should focus on improving the quality of antibiotic prophylaxis and closely monitoring patients who undergo open surgical procedures.

背景:确定阑尾切除术后手术部位感染(SSI)的危险因素可能有助于重点预防方案。目的:目前的研究旨在确定来自卡塔尔西部单一中心的患者队列中与SSI相关的危险因素。方法:本横断面研究于2013年1月至2016年9月在古巴医院(卡塔尔Dukhan)对接受阑尾切除术的患者进行。从患者档案中提取的数据包括人口统计学、合并症和中毒习惯、手术类型、手术时间、伤口类型、阑尾炎类型、美国麻醉评分、体重指数、选定的实验室检查和抗生素预防的依从性。结果:单因素分析发现，手术类型、手术时间、伤口和阑尾炎类型、血清白蛋白和抗生素预防时间与SSI的发生有关(P = 0.000)。Logistic回归分析显示，开放性阑尾切除术(优势比[OR] = 22.90, 95% CI;8.04-65.21)，低血清白蛋白(OR = 0.92, 95% CI;0.85-0.99)，以及抗生素预防时机不当(OR = 44.92, 95% CI;3.39-594.91)与SSI的发生独立相关。结论:复杂阑尾炎病例、开放性手术、低血清白蛋白水平和抗生素预防时机不当是本研究中发生SSI的危险因素。感染控制程序应侧重于提高抗生素预防的质量，并密切监测接受开放性手术的患者。

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引用次数: 1

The Future of Healthcare Facilities: How Technology and Medical Advances May Shape Hospitals of the Future 医疗设施的未来:技术和医学进步如何塑造未来的医院

Hospital Practices and Research

Pub Date : 2019-02-28 DOI: 10.15171/HPR.2019.01

Mohsen Vatandoost, Sanaz Litkouhi

In this review article, we aim to depict how healthcare facilities may look in the near future from an architectural design point of view. For this purpose, we review newly introduced technology and medical advances in the field of healthcare, such as artificial intelligence (AI), robotic surgery, 3D printing, and information technology (IT), and suggest how those advances may affect the architectural design of future healthcare facilities. In future hospitals, less space will be required; there will be no need for waiting areas. Most care will be given far from the hospital. Every human might have a computer chip attached to his body, with all his medical data ready and monitored by AI. In the future, all processes may be done by robots and AI, from reception to detection (radiology, scans, etc.). Nearly all surgery will be done by robots, so the architectural design of operation departments will need to be changed accordingly. AI is faster and better in disease detection than man; thus, there will be no need for laboratories or detection departments as we know them now. 3D printers are able to print almost everything from medical equipment to parts of the human body; thus, space will be needed for scanning and 3D printing in future hospitals. 3D printers might change the pharmaceutical industries, and drugs will be produced for any human individually.

在这篇综述文章中，我们旨在从建筑设计的角度描述医疗保健设施在不久的将来的样子。为此，我们回顾了医疗保健领域新引入的技术和医学进步，如人工智能(AI)、机器人手术、3D打印和信息技术(IT)，并建议这些进步如何影响未来医疗保健设施的建筑设计。在未来的医院，将需要更少的空间;将不需要等候区。大多数护理将在远离医院的地方进行。每个人的身体上可能都有一个电脑芯片，所有的医疗数据都准备好了，并由人工智能监控。在未来，从接收到检测(放射、扫描等)，所有的过程都可能由机器人和人工智能完成。几乎所有的手术都将由机器人完成，因此手术部门的建筑设计将需要相应的改变。人工智能在疾病检测方面比人类更快更好;因此，将不需要我们现在所知道的实验室或检测部门。3D打印机能够打印从医疗设备到人体部位的几乎所有东西;因此，未来的医院将需要空间进行扫描和3D打印。3D打印机可能会改变制药行业，药物将为每个人单独生产。

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引用次数: 15

Improvement of Psychological Symptoms After Replacement Therapy With Levothyroxine in Hypothyroidism: A Report of 2 Cases 甲状腺功能减退患者左旋甲状腺素替代治疗后心理症状改善2例报告

Hospital Practices and Research

Pub Date : 2019-02-16 DOI: 10.15171/HPR.2019.06

R. Bidaki, B. Tavana, S. Hosseini, Negar Neshati, M. Zarch

Introduction: Hypothyroidism is a common disorder of the endocrine system in which the production of thyroid hormones is inadequate. In addition to various physical manifestations, patients who suffer from hypothyroidism may also present with psychological problems, as described in previous studies. Case Presentation: Herein, the reports of 2 patients who suffered from hypothyroidism and experienced improvement in their psychological symptoms after levothyroxine therapy are presented. The patients referred with depressive mood with psychotic features and psychomotor retardation. Treatment simultaneously with psychopharmacotherapy and hormone therapy was considered. Conclusion: Although hypothyroidism and depressive disorders are separate issues, hypothyroidism can induce depression and psychosis, and psychopharmacotherapy plus hormone therapy can be effective and boost treatment.

简介:甲状腺功能减退症是内分泌系统的一种常见疾病，其中甲状腺激素的分泌不足。除各种生理表现外，甲状腺功能减退症患者还可能出现心理问题，如以往研究所述。病例介绍:本文报告2例甲状腺功能减退患者经左甲状腺素治疗后心理症状有所改善。患者为抑郁情绪伴精神病性特征和精神运动迟缓。同时考虑精神药物治疗和激素治疗。结论:虽然甲状腺功能减退与抑郁症是两个独立的问题，但甲状腺功能减退可诱发抑郁和精神病，精神药物治疗加激素治疗可有效促进治疗。

引用次数: 0

Economic Performance Analysis of Selected Military Hospitals Using Hospital Indicators and Inpatient Bed-Day Cost 基于医院指标和住院床位日成本的选定军队医院经济绩效分析

Hospital Practices and Research

Pub Date : 2019-01-30 DOI: 10.15171/HPR.2019.05

E. Teymourzadeh, M. Bahadori, M. Meskarpour-Amiri, Javad Khoshmanzar, S. Hosseini-Shokouh

Background: Hospitals, the main providers of healthcare services, are costly centers which account for about 80% of the health sector budget and have a huge share of resources. Objective: This study aimed to analyze the economic performance of selected military hospitals in Tehran using hospital indicators and inpatient bed-day costs. Methods: This descriptive, cross-sectional, retrospective study conducted in hospitals affiliated with a military medical university. Data was collected with forms completed by referring to the hospitals’ finance and accounting, medical records, staffing, and logistics departments. The extracted data converted to hospital indicators using the appropriate formulas and analyzed using Excel and SPSS software with the T-test. Results: The average bed occupancy rate (BOR) was 71%, the average length of stay (ALOS) was 2.5 days, the average bed turnover (BT) was 31 times, and the average bed turnover interval (BTI) was one day. The comparison of means of all the above-mentioned indicators other than BOR with the national standards was statistically significant (P < 0.05). Inpatient bedday costs with and without capital costs were calculated to be 3312353 IRR and 12253775 IRR, respectively. Conclusion: Higher BOR and BT and lower ALOS and BTI indicators were appropriate compared with the national standards, but the cost performance was not appropriate. An unreasonable increase in inpatient bed-day cost revealed that there were unused beds and that hospitals had no monitoring systems for revenues and expenditures. Therefore, serious attention must be given to the scientific criteria and principles of health economics to improve resource productivity.

背景:医院是医疗保健服务的主要提供者，是昂贵的中心，约占卫生部门预算的80%，拥有巨大的资源份额。目的:本研究旨在利用医院指标和住院病人床位日成本分析德黑兰选定军队医院的经济绩效。方法:在某军医大学附属医院进行描述性、横断面、回顾性研究。通过参考医院的财务和会计、医疗记录、人员配备和后勤部门填写表格收集数据。提取的数据采用相应的公式转化为医院指标，使用Excel和SPSS软件进行t检验分析。结果:平均床位入住率(BOR)为71%，平均住院时间(ALOS)为2.5 d，平均换床次数(BT)为31次，平均换床间隔(BTI)为1 d。所有上述指标的比较方式除了BOR与国家标准具有统计学意义(P < 0.05)。计入和不计入资金成本的住院住院日成本分别为3312353 IRR和12253775 IRR。结论:与国家标准相比，较高的BOR、BT和较低的ALOS、BTI指标较为合适，但性价比不合适。住院病人床位日费用的不合理增长表明有未使用的床位，医院没有对收入和支出的监控系统。因此，必须重视卫生经济学的科学标准和原则，以提高资源生产率。

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引用次数: 4

Sporadic Burkitt Lymphoma: A Case Report 散发性伯基特淋巴瘤1例报告

Hospital Practices and Research

Pub Date : 2019-01-28 DOI: 10.15171/HPR.2019.07

Edgar Vargas Flores, Claudia Leticia Avitia Raygoza, Daniel Hernández Castañeda, Jorge Arturo Sánchez Garza, J. Cortez

Introduction: Burkitt lymphoma is an aggressive subtype of Hodgkin lymphoma with a doubling time of 25 hours. It is characterized by a MYC gene coding alteration which results from a translocation of chromosome 8 on the MYC gene locus and immunoglobulin heavy-chain locus (IGH) on chromosome 14. Even though HIV infection is associated to an increased risk of Burkitt lymphoma, these type of malignancies are EBV-negative cases. Sporadic type Burkitt lymphoma is a rare clinical entity. Case Presentation: A 48-year-old female without any past medical history presented with a chief complaint of mild abdominal pain of 6 months duration located at the epigastrium which was not related to food ingestion. Nausea or vomiting were neither reported. She noted an acute increased abdominal pain over the last 4 hours before presentation, with irradiation to the right lower quadrant. She denied any Fever, night sweats and weight loss. She also reported hypermenorrhea in the last 6 months. During the physical examination, a palpable mass with 10 cm in diameter was found on right lower quadrant. Conclusion: Sporadic Burkitt lymphoma is one of the rarest hematologic malignancies. The increased tumor size may be more than enough to show clinical or biochemical abnormalities such as serum lactate dehydrogenase (LDH) increased and tumor lysis.

伯基特淋巴瘤是霍奇金淋巴瘤的一种侵袭性亚型，复发时间为25小时。其特征是MYC基因编码改变，这是由8号染色体上的MYC基因位点和14号染色体上的免疫球蛋白重链位点(IGH)易位引起的。尽管HIV感染与伯基特淋巴瘤的风险增加有关，但这些类型的恶性肿瘤是ebv阴性病例。散发型伯基特淋巴瘤是一种罕见的临床疾病。病例介绍:48岁女性，既往无任何病史，主诉为上腹轻度腹痛6个月，与食物摄入无关。没有恶心或呕吐的报告。在就诊前的最后4小时内，她注意到右下腹照射，急性腹痛加重。她否认发烧、盗汗和体重减轻。她在过去的六个月里也有月经过多的症状。体格检查时发现右下腹可触及直径10cm的肿块。结论:散发性伯基特淋巴瘤是一种罕见的血液恶性肿瘤。增大的肿瘤大小可能足以显示临床或生化异常，如血清乳酸脱氢酶(LDH)升高和肿瘤溶解。

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引用次数: 1

Prevalence and Risk Factors for Chronic Kidney Disease in Family Relatives of a Cameroonian Population of Hemodialysis Patients: A CrossSectional Study 喀麦隆血液透析患者家庭亲属中慢性肾脏疾病的患病率和危险因素:一项横断面研究

Hospital Practices and Research

Pub Date : 2019-01-26 DOI: 10.15171/HPR.2019.02

M. Temgoua, G. Ashuntantang, M. Essi, J. Tochie, M. Oumarou, A. Abongwa, A. Mbonda, S. Kingue

Background: In sub-Saharan Africa (SSA), the trend in the number of patients admitted for maintenance hemodialysis is on the rise. The identification of risk factors for chronic kidney disease (CKD) ensures adequate primary and secondary preventive measures geared at reducing the burden of CKD in low-resource settings. A family history of CKD is an established risk factor for CKD in high-income countries. However, data on family predisposition to CKD is scarce in the literature on SSA. Objective: The current study aimed to determine the prevalence and risk factors of CKD in family relatives of a Cameroonian population of hemodialysis patients (HDP) followed-up in a major hemodialysis referral center in Cameroon. Methods: The current cross-sectional study was conducted over four months on a consecutive sample of first-degree family relatives of end-stage renal disease patients undergoing maintenance hemodialysis at the hemodialysis unit of the General Hospital of Yaoundé. For each participating family relative, socio-demographic characteristics, clinical data, and biological data including fasting blood glucose, proteinuria, and serum creatinine were collected. Results: A total of 82 first-degree family relatives of HDP were recruited. The prevalence of CKD among the participants was 15.8%. The main identified risk factors for CKD were age (P = 0.0015), female gender (P = 0.0357), hypertension (P = 0.0004), regular intake of herbal remedies (P = 0.0214), and diabetes mellitus (P = 0.0019). Conclusion: Overall, the current findings suggest an urgent need for population education, routine screening of CKD, and the identification of risk factors in first-degree family relatives of HDP in Cameroon.

背景:在撒哈拉以南非洲(SSA)，接受维持性血液透析的患者人数呈上升趋势。确定慢性肾脏疾病(CKD)的危险因素可确保采取适当的一级和二级预防措施，以减轻低资源环境中CKD的负担。在高收入国家，CKD家族史是CKD的一个确定的危险因素。然而，在关于SSA的文献中，关于CKD家族易感性的数据很少。目的:本研究旨在确定在喀麦隆主要血液透析转诊中心随访的喀麦隆血液透析患者(HDP)家庭亲属中CKD的患病率和危险因素。方法:本横断面研究是在姚文德总医院血液透析科接受维持性血液透析治疗的终末期肾病患者的一级家庭亲属中连续取样4个月。收集每个参与研究的家庭亲属的社会人口学特征、临床数据和生物学数据，包括空腹血糖、蛋白尿和血清肌酐。结果:共纳入HDP一级直系亲属82例。参与者中CKD患病率为15.8%。CKD的主要危险因素为年龄(P = 0.0015)、女性(P = 0.0357)、高血压(P = 0.0004)、经常服用中草药(P = 0.0214)、糖尿病(P = 0.0019)。结论:总的来说，目前的研究结果表明，喀麦隆迫切需要进行人口教育，常规筛查CKD，并确定HDP一级家庭亲属的危险因素。

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引用次数: 3

Atomoxetine Induced Obsessive-Compulsive Disorder 托莫西汀诱发的强迫症

Hospital Practices and Research

Pub Date : 2019-01-26 DOI: 10.15171/HPR.2019.12

M. Altay

Introduction: Attention deficit and hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents. Atomoxetine is a non-stimulant drug used in the treatment of ADHD. Case Presentation: In this article, a case of obsessive-compulsive disorder (OCD) which occurred in an 11-year-old boy with an increased dose of atomoxetine during ADHD treatment and disappeared with dose reduction is reported. This case is only the second OCD case resulting from the use of atomoxetine. Conclusion: The case reported herein is the second case caused by the use of atomoxetine and the first in which OCD symptoms regressed when the atomoxetine dose was reduced. OCD development due to atomoxetine consumption may occur at different doses. When OCD develops, the solution may be dose reduction, or it may be necessary to discontinue treatment with atomoxetine.

注意缺陷多动障碍(ADHD)是儿童和青少年中一种常见的神经发育障碍。托莫西汀是一种用于治疗多动症的非兴奋剂药物。病例介绍:本文报告了一例11岁男孩的强迫症(OCD)，在ADHD治疗期间增加了阿托西汀的剂量，并随着剂量的减少而消失。这只是第二个使用托莫西汀导致的强迫症病例。结论:本文报告的病例是第二例使用阿托西汀引起的病例，也是第一例减少阿托西汀剂量后强迫症症状有所缓解的病例。服用不同剂量的托莫西汀可引起强迫症。当出现强迫症时，解决方案可能是减少剂量，或者可能需要停止使用托莫西汀治疗。

引用次数: 2

Cognitive Errors and Psychological Resilience in Patients With Social Anxiety and Obsessive-Compulsive Disorder: A Cross-Sectional Study 社交焦虑和强迫症患者的认知错误和心理弹性:一项横断面研究

Hospital Practices and Research

Pub Date : 2019-01-26 DOI: 10.15171/HPR.2019.04

L. Ebrahimi, Seyedeh Elnaz Mousavi, B. Gharraee, Jahangir Mohammadi Bytamar, M. S. Isfeedvajani

Background: Cognitive errors have been presented as effective factors in the creation and continuation of obsessive– compulsive disorder and social anxiety disorder. Psychological resilience is an important factor in the tolerance of cognitive errors. Objective: The present study aimed to compare cognitive errors and the psychological resilience of patients with social anxiety disorder and those with obsessive–compulsive disorder. Methods: This cross-sectional study investigated a total of 60 patients, 30 with social anxiety disorder and 30 with obsessivecompulsive disorder (OCD), seen at a hospital in Zanjan city, Iran, in 2017. Participants were aged between 15 and 50 years. Participants were chosen using convenience sampling and on the basis of psychiatrist diagnosis and structured diagnostic interviews (SCID-I, II) according to the inclusion and exclusion criteria. The Cognitive Errors Questionnaire (CET) and the Connor-Davidson Resilience Scale (CD-RISC) were used to assess the variables. Results: A significant difference was observed between the two patient groups in the cognitive errors components (P≤0.05). In patients with OCD, the highest average rate of cognitive errors was related to catastrophizing and splitting error. In patients with SAD, the highest mean rate of cognitive errors was related to catastrophizing. There was no significant difference in psychological resilience between the two groups. Conclusion: Cognitive errors play an important role in OCD and social anxiety disorder (SAD). OCD patients were observed to make more cognitive errors than SAD patients. However, psychological resilience was equal between both groups.

背景:认知错误被认为是强迫症和社交焦虑障碍产生和持续的有效因素。心理弹性是认知错误容忍度的重要因素。目的:比较社交焦虑障碍患者与强迫症患者的认知错误和心理弹性。方法:本横断面研究调查了2017年在伊朗赞詹市一家医院就诊的60例患者，其中30例患有社交焦虑症，30例患有强迫症(OCD)。参与者的年龄在15到50岁之间。根据纳入标准和排除标准，采用方便抽样方法，在精神科医生诊断和结构化诊断访谈(SCID-I, II)的基础上选择参与者。采用认知错误问卷(CET)和康诺-戴维森弹性量表(CD-RISC)对变量进行评估。结果:两组患者在认知错误成分上差异有统计学意义(P≤0.05)。在强迫症患者中，认知错误的平均发生率最高的是灾难化和分裂错误。在SAD患者中，最高的平均认知错误率与灾难化有关。两组的心理弹性无显著差异。结论:认知错误在强迫症和社交焦虑障碍(SAD)中起重要作用。强迫症患者比SAD患者出现更多的认知错误。然而，两组之间的心理弹性是相等的。

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引用次数: 5

Minorities' Diminished Returns of Educational Attainment on Hospitalization Risk: National Health Interview Survey (NHIS). 少数民族受教育程度对住院风险的递减回报：全国健康访谈调查（NHIS）。

Hospital Practices and Research

Pub Date : 2019-01-01 Epub Date: 2019-09-18 DOI: 10.15171/HPR.2019.17

Shervin Assari, Mohsen Bazargan

Background: As suggested by the Minorities' Diminished Returns (MDRs) theory, educational attainment shows a weaker protective effect for racial and ethnic minority groups compared to non-Hispanic Whites. This pattern, however, is never shown for hospitalization risk.

Objectives: This cross-sectional explored racial and ethnic variation in the association between educational attainment and hospitalization in the US.

Methods: Data came from the National Health Interview Survey (NHIS 2015). The total sample was 28,959 American adults. Independent variables were educational attainment and hospitalization. The main outcome was hospitalization during the last 12 months. Age, gender, employment, marital status, region, obesity, and the number of cardiovascular conditions were covariates. Race and ethnicity were the effect modifiers. Logistic regression models were utilized to analyze the data.

Results: From all participants, 16.2% were Black and 11.6 were Hispanic, with a mean age of 51 years old. Overall, higher education levels were associated with lower odds of hospitalization, independent of all confounders. Educational attainment showed significant interactions with race (OR =1.04, 95% CI = 1.01 - 1.08) and ethnicity (OR = 1.04, 95% CI =1.01 -1.07) on hospitalization, indicating smaller protective effects of educational attainment on hospitalization of Hispanics and Blacks than non-Hispanic Whites.

Conclusion: The protective effect of educational attainment on population health is smaller for Blacks and Hispanics compared to non-Hispanic Whites. To prevent health disparities, there is a need to minimize diminished returns of educational attainment for racial and ethnic minorities. To do so, there is a need for innovative and bold economic, public, and social policies that do not limit themselves to equalizing socioeconomic status but also help minorities leverage their available resources and gain tangible outcomes.

背景：正如少数族裔的递减回报（MDR）理论所表明的那样，与非西班牙裔白人相比，教育程度对种族和少数族裔群体的保护作用较弱。然而，这种模式从未显示出住院风险。目的：本横断面调查探讨了美国受教育程度与住院之间的种族和民族差异。方法：数据来自全国健康访谈调查（NHIS 2015）。总样本为28959名美国成年人。自变量是受教育程度和住院时间。主要结果是在过去12个月内住院治疗。年龄、性别、就业、婚姻状况、地区、肥胖和心血管疾病的数量是协变量。种族和民族是效果修饰因子。采用Logistic回归模型对数据进行分析。结果：在所有参与者中，16.2%是黑人，11.6是西班牙裔，平均年龄为51岁。总体而言，较高的教育水平与较低的住院几率相关，与所有混杂因素无关。受教育程度与住院时的种族（OR=1.04，95%CI=1.01-1.08）和民族（OR=1.04,95%CI=1.01-1.07）有显著的交互作用，表明受教育程度对西班牙裔和黑人住院的保护作用小于非西班牙牙裔白人。为了防止健康差距，有必要尽量减少少数种族和族裔受教育程度回报的减少。要做到这一点，就需要创新和大胆的经济、公共和社会政策，这些政策不仅限于平等的社会经济地位，而且还帮助少数群体利用其可用资源并取得切实成果。

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引用次数: 0