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首页> 外文期刊>International Journal of Environmental Research and Public Health >Prediction of Unmet Primary Care Needs for the Medically Vulnerable Post-Disaster: An Interrupted Time-Series Analysis of Health System Responses
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Prediction of Unmet Primary Care Needs for the Medically Vulnerable Post-Disaster: An Interrupted Time-Series Analysis of Health System Responses

机译：对医疗脆弱的灾后未满足的初级保健需求的预测：卫生系统响应的中断时间序列分析

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摘要

Disasters serve as shocks and precipitate unanticipated disturbances to the health care system. Public health surveillance is generally focused on monitoring latent health and environmental exposure effects, rather than health system performance in response to these local shocks. The following intervention study sought to determine the long-term effects of the 2005 chlorine spill in Graniteville, South Carolina on primary care access for vulnerable populations. We used an interrupted time-series approach to model monthly visits for Ambulatory Care Sensitive Conditions, an indicator of unmet primary care need, to quantify the impact of the disaster on unmet primary care need in Medicaid beneficiaries. The results showed Medicaid beneficiaries in the directly impacted service area experienced improved access to primary care in the 24 months post-disaster. We provide evidence that a health system serving the medically underserved can prove resilient and display improved adaptive capacity under adverse circumstances (i.e., technological disasters) to ensure access to primary care for vulnerable sub-groups. The results suggests a new application for ambulatory care sensitive conditions as a population-based metric to advance anecdotal evidence of secondary surge and evaluate pre- and post-health system surge capacity following a disaster.
机译：灾难会造成冲击，并给医疗保健系统带来意想不到的干扰。公共卫生监督通常集中于监视潜在的健康和环境暴露影响，而不是针对这些局部冲击的卫生系统绩效。以下干预研究试图确定2005年南卡罗来纳州Graniteville发生氯泄漏对弱势人群提供初级保健的长期影响。我们使用了间断的时间序列方法来模拟“非卧床护理敏感状况”的每月访问量（这是未满足初级护理需求的指标），以量化灾难对医疗补助受益人中未满足的初级护理需求的影响。结果表明，受灾地区的医疗补助受益人在灾后24个月内获得了更好的初级保健服务。我们提供的证据表明，在不利条件下（即技术灾难），为医疗不足的医疗服务的医疗系统可以证明具有韧性并显示出增强的适应能力，以确保弱势群体能够获得初级保健。结果表明，轮流护理敏感条件作为一种基于人口的度量标准得到了新的应用，可以提高继发性电涌的轶事证据，并评估灾难后卫生系统前后的电涌能力。

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