上肢矫形手术入院患者违抗医嘱离院的风险因素。

David Momtaz, Umar Ghilzai, Shawn Okpara, Abdullah Ghali, Rishi Gonuguntla, Travis Kotzur, Kai Zhu, Ali Seifi, Ryan Rose
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引用次数: 0

摘要

导言:违背医嘱(AMA)离院的患者面临着更大的负面健康后果风险,这对医疗保健系统来说是一个挑战。本研究探讨了与上肢(UE)矫形手术后离开AMA的患者相关的人口统计学和住院过程因素:我们利用医疗成本与利用项目数据库分析了 2011 年至 2020 年间接受上肢矫形手术的 262,912 名患者。然后,我们比较了离开AMA和未离开AMA的患者的人口统计学和住院过程因素:在 262,912 名 UE 骨科患者中,0.45%(1,173 人)离开了 AMA。更有可能离开AMA的患者年龄在30至49岁之间(OR,5.953,P<0.001)、黑人(OR,1.708,P<0.001)、有医疗补助(OR,3.436,P<0.001)、收入在第1至25百分位数之间(OR,1.657,P<0.001)。女性患者比男性患者更不可能离开AMA(OR,0.647,P < 0.001)。离开AMA的患者住院时间更长(3.626天对2.363天,P < 0.001),康复时间更长(2.733天对1.977天,P < 0.001):我们发现,男性、黑人、49 岁以下、有医疗补助保险和最低收入四分位数的患者在接受 UE 骨科治疗后更有可能离开 AMA。
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Risk Factors for Leaving Against Medical Advice in Patients Admitted for Upper Extremity Orthopedic Procedures.

Introduction: Patients who leave against medical advice (AMA) face increased risks of negative health outcomes, presenting a challenge for healthcare systems. This study examines demographic and hospital course factors associated with patients leaving AMA after an upper extremity (UE) orthopaedic procedure.

Methods: We analyzed 262,912 patients who underwent UE orthopaedic procedures between 2011 and 2020, using the Healthcare Cost and Utilization Project database. We then compared demographic and hospital course factors between patients who left AMA and those who did not leave AMA.

Results: Of 262,912 UE orthopaedic patients, 0.45% (1,173) left AMA. Those more likely to leave AMA were aged 30 to 49 (OR, 5.953, P < 0.001), Black (OR, 1.708, P < 0.001), had Medicaid (OR, 3.436, P < 0.001), and were in the 1st to 25th income percentile (OR, 1.657, P < 0.001). Female patients were less likely to leave AMA than male patients (OR, 0.647, P < 0.001). Patients leaving AMA had longer stays (3.626 versus 2.363 days, P < 0.001) and longer recovery times (2.733 versus 1.977, P < 0.001).

Conclusion: We found that male, Black, younger than 49 years old, Medicaid-insured, and lowest income quartile patients are more likely to leave AMA after UE orthopaedic treatment.

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来源期刊
CiteScore
2.60
自引率
6.70%
发文量
282
审稿时长
8 weeks
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