医疗补助注册儿童哮喘ED就诊率的相关因素:结构方程建模方法。

IF 0.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL AIMS Medical Science Pub Date : 2017-01-01 Epub Date: 2017-02-10 DOI:10.3934/medsci.2017.1.71
Luceta McRoy, George Rust, Junjun Xu
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引用次数: 0

摘要

背景:哮喘是美国学龄儿童急诊就诊和旷课的主要原因之一,但急诊就诊率在当地存在显著差异,种族间也存在显著差异。分析:我们首先使用多州数据集计算了医疗补助注册的5-12岁哮喘儿童的急诊就诊率。然后,我们使用226多个变量进行了探索性因素分析,以评估它们是否集中在三个被认为与哮喘ED就诊率变化相关的县级概念因素(社会经济地位、医疗能力和空气质量)周围。测量变量(包括作为感兴趣结果的ED就诊率)随后被标准化,并通过验证性因素分析在一个简单的概念模型中进行测试。结果:县一级(上下文)变量确实围绕概念模型中先验声明的因素进行聚类。将ED就诊率与社会经济地位、空气质量和医疗系统专业能力因素联系起来的结构方程模型(与我们的概念框架一致)汇聚在一个解决方案上,并在验证性因素分析中实现了合理的拟合优度。结论:验证性因素分析为定量检验哮喘相关急诊科使用中的局部地区差异和种族差异概念模型提供了一种方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Factors Associated with Asthma ED Visit Rates among Medicaid-enrolled Children: A Structural Equation Modeling Approach.

Background: Asthma is one of the leading causes of emergency department visits and school absenteeism among school-aged children in the United States, but there is significant local-area variation in emergency department visit rates, as well as significant differences across racial-ethnic groups.

Analysis: We first calculated emergency department (ED) visit rates among Medicaid-enrolled children age 5-12 with asthma using a multi-state dataset. We then performed exploratory factor analysis using over 226 variables to assess whether they clustered around three county-level conceptual factors (socioeconomic status, healthcare capacity, and air quality) thought to be associated with variation in asthma ED visit rates. Measured variables (including ED visit rate as the outcome of interest) were then standardized and tested in a simple conceptual model through confirmatory factor analysis.

Results: County-level (contextual) variables did cluster around factors declared a priori in the conceptual model. Structural equation models connecting the ED visit rates to socioeconomic status, air quality, and healthcare system professional capacity factors (consistent with our conceptual framework) converged on a solution and achieved a reasonable goodness of fit on confirmatory factor analysis.

Conclusion: Confirmatory factor analysis offers an approach for quantitatively testing conceptual models of local-area variation and racial disparities in asthma-related emergency department use.

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来源期刊
AIMS Medical Science
AIMS Medical Science MEDICINE, RESEARCH & EXPERIMENTAL-
自引率
14.30%
发文量
20
审稿时长
12 weeks
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