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首页> 外文期刊>The American Journal of Cardiology >Cardiovascular disease and risk in primary care settings in the United States
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Cardiovascular disease and risk in primary care settings in the United States

机译：美国初级保健机构的心血管疾病和风险

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Primary care site may play an important role in cardiovascular disease prevalence; however, the distribution of risk factors and outcomes across care sites is not known. In this study, a cross-sectional analysis of 21,778 adult participants from the National Health and Nutrition Examination Survey (NHANES; 1999 to 2008) using multivariate logistic regression was conducted to assess the relation between site of usual care and disease prevalence. Patients' self-reported histories of several chronic conditions (hypertension, diabetes, and hypercholesterolemia), awareness of chronic conditions, and associated cardiovascular events (angina, coronary heart disease, cardiovascular disease, myocardial infarction, and stroke) were examined. After adjustment for demographic and health care utilization characteristics, there were no significant differences in the prevalence of diabetes or hypercholesterolemia among patients receiving usual care at private doctors' offices, hospital outpatient clinics, community-based clinics, and emergency rooms (ER). However, participants without usual sources of care and those receiving usual care at ERs had significantly lower awareness of their chronic conditions than participants at other sites. The odds of having a history of each of the adverse cardiovascular events ranged from 2.21 to 4.18 times higher for patients receiving usual care at ERs relative to private doctors' offices. In conclusion, participants who report using ERs as their usual sites of care are disproportionately more likely to have histories of poor cardiovascular outcomes and are more likely to be unaware of having hypertension or hypercholesterolemia. As health care reform takes place and millions more begin seeking care, it is imperative to ensure access to longitudinal care sites designed for continuous disease management.
机译：初级保健场所可能在心血管疾病的流行中起重要作用;但是，尚不清楚各护理地点之间的危险因素和结果的分布。在这项研究中，采用多元logistic回归对来自国家健康和营养检查调查（NHANES; 1999年至2008年）的21,778名成年参与者进行了横断面分析，以评估日常护理地点与疾病患病率之间的关系。检查了患者自我报告的几种慢性病（高血压，糖尿病和高胆固醇血症）的病史，对慢性病的意识以及相关的心血管事件（心绞痛，冠心病，心血管疾病，心肌梗塞和中风）。在调整了人口统计学和医疗保健利用特征之后，在私人医生办公室，医院门诊，社区诊所和急诊室（ER）接受常规护理的患者中，糖尿病或高胆固醇血症的患病率无显着差异。但是，没有常规护理来源的参与者和在急诊室接受常规护理的参与者对慢性病的意识明显低于其他地点的参与者。相对于私家医生的办公室，在急诊室接受常规护理的患者，具有每次不良心血管事件史的几率高出2.21到4.18倍。总而言之，报告称使用ER作为其常规护理地点的参与者更有可能具有心血管预后不良的病史，并且更有可能不知道患有高血压或高胆固醇血症。随着医疗保健改革的进行以及数以百万计的人开始寻求医疗保健，必须确保能够进入专为持续疾病管理而设计的纵向医疗保健场所。

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