父母伤害的后果:对儿童保健利用的影响和保健的经济障碍。

IF 3.9 2区 医学 Q2 CRITICAL CARE MEDICINE Journal of Trauma and Acute Care Surgery Pub Date : 2025-05-01 Epub Date: 2025-02-10 DOI:10.1097/TA.0000000000004553
Arnav Mahajan, Ruchika Kamojjala, Saba Ilkhani, Caleb W Curry, Penelope Halkiadakis, Prerna Ladha, Megen Simpson, Sarah A Sweeney, Vanessa P Ho
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引用次数: 0

摘要

背景:非故意创伤性伤害是一个重大的公共卫生挑战,不仅影响到受伤的个人,也影响到他们的家庭。现有的研究主要集中在儿童受伤对其家庭的影响上,而很少关注父母受伤对儿童健康的影响。本研究旨在探讨父母意外伤害对儿童健康结果、医疗保健利用和社会经济障碍的影响。方法:我们利用2020年、2021年和2023年全国健康访谈调查(NHIS)的数据,创建父母受伤的亲子二联体。受伤的定义是对受伤的积极反应,并在受伤后寻求医疗咨询。研究对象包括5岁至17岁的儿童及其父母。研究了三个结果域:健康结果、卫生保健利用和社会经济健康影响。采用双变量和逻辑回归分析来评估父母伤害对这些结果的影响。结果:我们确定了414(加权= 1,338,068)对受伤的亲子和10,352对未受伤的亲子。父母受伤的儿童被诊断为注意缺陷多动障碍/注意缺陷障碍的几率更高(优势比[OR], 1.69;95%置信区间[CI], 1.31-2.40;p = 0.005),较高的华盛顿组综合残疾评分(OR, 1.77;95% ci, 1.25-2.47;p = 0.001),损伤几率增加(OR, 2.29;95% ci, 1.58-3.28;P < 0.001)。他们也显示出更高的紧急护理就诊率,急诊科就诊率明显更高(OR, 1.49;95% ci, 1.02-2.13;P = 0.03)。财务毒性显著,延迟的几率增加(OR, 2.37;95% ci, 1.14-5.40;p = 0.03)或避免护理(or, 3.06;95% ci, 1.06-7.76;P = 0.02)。结论:本研究强调了父母伤害对儿童的广泛影响,包括更差的健康结果、更多的医疗保健利用和重大的经济障碍。这些发现强调需要全面的创伤护理,以解决家庭的整体需求,并结合减轻健康和社会经济挑战的策略。证据水平:预后/流行病学;II级。
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The consequences of parental injury: Impacts on children's health care utilization and financial barriers to care.

Background: Unintentional traumatic injuries pose a significant public health challenge, impacting not only injured individuals but also their families. Existing research has largely focused on the effects of a child's injury on their family, with limited attention to the consequences of parental injury on children's health. This study aims to explore the consequences of unintentional parental injury on children's health outcomes, health care utilization, and socioeconomic barriers to care.

Methods: We utilized data from the National Health Interview Survey (NHIS) for 2020, 2021, and 2023, creating parent-child dyads where the parent was injured. Injury was defined by a positive response to experiencing an injury and seeking medical consultation after. Children aged 5 years to 17 years and their parents were included. Three outcome domains were examined: health outcomes, health care utilization, and socioeconomic health impacts. Bivariate and logistic regression analyses were conducted to assess the impact of parental injury on these outcomes.

Results: We identified 414 (weighted = 1,338,068) injured parent-child dyads and 10,352 noninjured dyads. Children of injured parents had higher odds of being diagnosed with attention-deficit hyperactivity disorder/attention-deficit disorder (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.31-2.40; p = 0.005), higher Washington Group Composite Disability Scores (OR, 1.77; 95% CI, 1.25-2.47; p = 0.001), and increased injury odds (OR, 2.29; 95% CI, 1.58-3.28; p < 0.001). They also showed higher rates of urgent care visits, with significantly higher emergency department visits (OR, 1.49; 95% CI, 1.02-2.13; p = 0.03). Financial toxicity was significant, with increased odds of delaying (OR, 2.37; 95% CI, 1.14-5.40; p = 0.03) or avoiding care (OR, 3.06; 95% CI, 1.06-7.76; p = 0.02) due to cost.

Conclusion: This study highlights the broad-reaching impact of parental injury on children, including worse health outcomes, increased health care utilization, and significant financial barriers. These findings underscore the need for comprehensive trauma care that addresses the holistic needs of families, incorporating strategies to mitigate both health and socioeconomic challenges.

Level of evidence: Prognostic and Epidemiological; Level III.

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来源期刊
CiteScore
6.00
自引率
11.80%
发文量
637
审稿时长
2.7 months
期刊介绍: The Journal of Trauma and Acute Care Surgery® is designed to provide the scientific basis to optimize care of the severely injured and critically ill surgical patient. Thus, the Journal has a high priority for basic and translation research to fulfill this objectives. Additionally, the Journal is enthusiastic to publish randomized prospective clinical studies to establish care predicated on a mechanistic foundation. Finally, the Journal is seeking systematic reviews, guidelines and algorithms that incorporate the best evidence available.
期刊最新文献
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