Patient and Hospital Factors Associated With Hospital Admissions for Ambulatory Care Sensitive Conditions

與門診照護敏感情況相關之病人與醫院因素

林正介(Cheng-Chieh Lin) ； 李采娟(Tsai-Chung Li) ； 陸寧(Ning Lu) ； 石磊玉(Leiyu Shi)

《Mid-Taiwan Journal of Medicine》 5卷1期 (2000/03) Pp. 1-15

https://doi.org/10.6558/MTJM.2000.5(1).1

摘要

背景　門診照護敏感情況指的是能以及時與有效的門診照護來預防疾病的產生或控制慢性病以降低住院機率的診斷，本研究所探討的門診照護敏感情況包括了細菌性肺炎、心絞痛、糖尿病、鬱血性心衰竭、氣喘、慢性阻塞性肺病、腎或尿道感染、高血壓、脫水及腸胃炎10種情況。本研究之主要目的為探討出院病人之門診照護敏感情況之盛行率，以及評估與門診照護敏感情況相關之病人與醫院因素。
方法 研究資料來自1994年美國國家醫院出院調查研究 （1994 National Hospital Discharge Survey），統計方法先以雙變項統計分析（bivariate analysis）方法比較門診照護敏感情況與非門診照護敏感情況在人口與醫院變項之差異，再以羅吉斯梅迴歸分析探討病人人口因子興醫院因子對門診照護敏感情況之相關。
結果 研究結果顯示出院病人之門診照敏感情況之盛行率為12%，公立、較小床位規模以及坐落於非西區之醫院有較高比率之門診照護敏感情況的出院病人，年齡、性別、種族、婚姻狀況、有無保險以及有無第二醫療保險則為顯著與門診照護敏感情況相關之病人因素。
結論 從本研究之結果顯示有系統的收集國家、州及社區之人口資料，醫療資源提供者與政策決策者將可容易且及時地評估不同人口醫療照護的需求及就醫的障礙。

關鍵字

相關因子 ； 門診照護敏感情況 ； 醫院因素 ； 病人因素 ； 盛行率

並列摘要

Background. Patients admitted into hospitals with ambulatory care sensitive (ACS) conditions generally lack adequate primary care or are not adequately managed on an ambulatory basis. This study explored the magnitude of discharges of patients with ACS condition in American hospitals and examined patient and hospital factors associated with hospital admissions for ACS conditions.
Methods. Data for this study was obtained from the 1994 National Hospital Discharge Survey. Bivariate statistical comparisons were performed to test the differences between ACS condition and non-ACS condition groups in specific demographics and hospital characteristics. Logistic regression was then applied to determine the independent effect of individual demographic and hospital factors in relation to hospitalizations for ACS conditions.
Results. We found that about 12% of the hospitalized patients were discharged with ACS conditions. Hospitals likely to have a higher rate of ACS discharges were governmental, relatively small in terms of beds, and situated in the non-West region. Patients likely to be discharged with ACS conditions were older, male, African American, unmarried, without insurance, or without an expected secondary source of payment. Conclusions. Using regularly collected hospital discharge data at the national, state, and community levels, providers and decision makers can easily make timely assessments about population needs and the extent of access barriers faced by special population groups.

並列關鍵字

affecting factors ； ambulatory care sensitive condition ； hospital factor ； patient factor ； prevalence