Jaime Barrio-Cortes, Beatriz Benito-Sánchez, Raquel Sánchez-Ruano, César Alfonso García-Hernández, María Teresa Beca-Martínez, María Martínez-Cuevas, Almudena Castaño-Reguillo, Cristina Muñoz-Lagos
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引用次数: 0
摘要
儿科慢性病患者的护理需求经常得不到满足,他们会大量使用医疗保健服务,而且经常会遇到零散的、非以患者为中心的护理。本研究旨在根据性别、年龄和病情复杂程度,分析这些患者在使用初级保健(PC)和医院护理(HC)服务方面的差异,并找出相关因素。这项横断面研究在马德里的一个基础医疗区进行,包括 18 岁以下的患者。在这些患者中,15.7%≥患有一种慢性疾病,54.1%为男性,平均年龄为9.5岁,3.5%病情复杂,11.3%患有多种疾病。与医疗系统的平均接触次数为 9.1 次/年,其中与 PC 的接触次数为 8.3 次/年(与儿科医生的接触次数为 4.9 次/年,与护士的接触次数为 1.9 次/年),与 HC 的接触次数为 0.8 次/年(外部咨询 0.8 次/年,住院 0.01 次/年)。与使用 PC 相关的因素有:复杂性;女性;欧洲血统;以及哮喘、癫痫、中风、反复泌尿感染、注意缺陷多动障碍和焦虑等疾病,而年龄偏大则呈负相关。甲状腺疾病与使用 HC 显著相关。这些发现有助于指导设计优化的儿科以患者为中心的护理方法,以协调各医疗服务机构的护理工作,减少医疗服务的高使用率,从而改善这些患者的医疗效果和生活质量。
Utilization of Healthcare Services in Patients with Chronic Diseases under 18 Years Old: Differences and Contributing Factors.
Pediatric patients with chronic conditions frequently have unmet care needs, make extensive use of healthcare services, and often encounter fragmented, non-centered care. This study aimed to analyze the differences in the utilization of primary care (PC) and hospital care (HC) services by these patients according to sex, age, and complexity and to identify associated factors. A cross-sectional study was conducted in a basic health area of Madrid, including patients under 18 years. Among these patients, 15.7% had ≥1 chronic disease, 54.1% were male, the average age was 9.5 years, 3.5% had complexity, and 11.3% had multimorbidity. The mean number of contacts/year with the healthcare system was 9.1, including 8.3 contacts/year with PC (4.9 with pediatricians and 1.9 with nurses) and 0.8 contacts/year with HC (0.8 in external consultations and 0.01 hospitalizations). The factors associated with PC utilization were complexity; female sex; European origin; and diseases like asthma, epilepsy, stroke, recurrent urinary infection, attention deficit hyperactivity disorder, and anxiety, while older age was negatively associated. Thyroid disorders were significantly associated with HC utilization. These findings could help guide the design of optimized pediatric patient-centered care approaches to coordinate care across healthcare services and reduce high healthcare utilization, therefore improving the healthcare outcomes and quality of life for these patients.
期刊介绍:
Journal of Personalized Medicine (JPM; ISSN 2075-4426) is an international, open access journal aimed at bringing all aspects of personalized medicine to one platform. JPM publishes cutting edge, innovative preclinical and translational scientific research and technologies related to personalized medicine (e.g., pharmacogenomics/proteomics, systems biology). JPM recognizes that personalized medicine—the assessment of genetic, environmental and host factors that cause variability of individuals—is a challenging, transdisciplinary topic that requires discussions from a range of experts. For a comprehensive perspective of personalized medicine, JPM aims to integrate expertise from the molecular and translational sciences, therapeutics and diagnostics, as well as discussions of regulatory, social, ethical and policy aspects. We provide a forum to bring together academic and clinical researchers, biotechnology, diagnostic and pharmaceutical companies, health professionals, regulatory and ethical experts, and government and regulatory authorities.