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背景由于针对哮喘急性发作的早期治疗可以预防疾病恶化,因此获得全科医疗可能是哮喘患者紧急入院的一个决定性因素。目的分析获得基层医疗是否与哮喘患者紧急入院相关。设计与环境横断面分析2010—2011年英国实践的数据。方法采用负二项回归法,探讨哮喘患者紧急入院与全科医生提供的全科医疗服务—调查中患者自述获得7项全科医疗服务措施,实践中控制研究对象的一般特征。计算发生率比(IRR)。结果具备所有项目数据者7 806例(95%)。3 134 106例哮喘患者中共55 570例因哮喘紧急入院。具有较高的综合分数的研究对象入院率较低[调整IRR=0.679,95%CI(0.665,0.708)]。研究对象中白人所占比例较高,在质量和结果框架指标“过去15个月内的哮喘评估”中表现欠佳者入院率较高。假设这些关联有因果关系,对于本次研究,10%的综合分数较高与每年减少的17 837例入院患者有关。结论实践中综合分数较高的哮喘患者紧急入院率较低。政策制定者应考虑改善基层医疗的可及性,作为帮助预防哮喘患者紧急入院的一种可能方式。
Background Since early treatment of an acute exacerbation of asthma can prevent the disease from deteriorating, obtaining general practice may be a deciding factor in the emergency admission of asthma patients. Objective To analyze whether primary care is associated with emergency admission to asthma patients. Cross-sectional design and environment analysis of 2010-2011 UK practice data. Methods The negative binomial regression method was used to investigate the emergency admission and general practitioner services provided by general practitioners. In the survey, seven general medical service measures were readjusted and the general characteristics of controlled subjects in practice were investigated. Calculate Incidence Rate (IRR). Results 7 806 patients (95%) with all project data. 3,135,570 cases of 106 asthma patients were admitted to hospital for asthma. Study participants with higher overall scores had a lower admission rate [adjusted IRR = 0.679, 95% CI (0.665, 0.708)]. Whilst the proportion of whites in the study population was high, there was a high rate of admission to poor performing patients in the Quality and Outcome Frame Index, Asthma Assessments in the Past 15 Months. Assuming a causal link between these associations, a higher overall composite score of 10% for this study is associated with a decrease of 17 837 admissions per year. Conclusions In practice, asthma patients with higher comprehensive scores have lower emergency admission rates. Policymakers should consider improving access to primary care as a possible way to help prevent emergency admission to patients with asthma.