哮喘联盟

   摘要
   背景：对于急诊患者来说，哮喘和高血压很常见。虽然初级保健医生对哮喘和高血压患者给予全面治疗，但这两种疾病的患者仍经常急诊就诊。
   目的：探讨哮喘或高血压急诊就诊患者的疾病治疗情况，并研究其与社会人口因素以及疾病严重程度的关联性。
   方法：对2008年6.4－8.31期间就诊于一家县级医院急诊科的患者进行前瞻性横断面研究。在获得患者的知情同意后，我们对其适当地进行最大呼气流量检测及血压测量。如果患者自述得到初级保健医生的处理或得到哮喘及高血压相关处方治疗，或两者同时发生，则定义为疾病得到治疗。采用描述性统计学方法以及多元逻辑回归模型分析相关数据。
   结果：总共纳入了2303例急诊患者，其中283例患有哮喘，543例患有高血压，187例同时患有哮喘和高血压。71例哮喘患者（25.1%）、151例高血压患者（27.8%）以及19例同时患有哮喘和高血压的患者（10.2%）没有得到很好的治疗。寻求急诊治疗的患者为同时患有哮喘及高血压且没有得到治疗的患者。女性哮喘患者较少得到治疗。在高血压患者中，健康状况及住房情况很好或较好的、年龄较轻的那部分患者获得较好的治疗；而血压越高，其得到的治疗越少。
   结论：寻求急诊治疗与患者没有得到较好的治疗和较差的社会经济地位相关。改善患者的治疗情况可能会影响急诊的就诊人数，但不能改变疾病的严重程度。
 

（杨冬 审校）
JEmergMed.2015Feb2.pii:S0736-4679(14)01337-7.doi:10.1016/j.jemermed.2014.12.015. [Epub ahead of print]


 

Access to Disease Treatment Among Patients Presenting to the Emergency Department with Asthma or Hypertension.
 

Johnson T1, Patel R1, Scott N1, Olives T1, Smith S1, Gray R1, Miner JR1.
 

ABSTRACT
BACKGROUND: Asthma and hypertension are common among Emergency Department (ED) patients. Primary care providers are integral in managing these conditions, yet these patients are often in the ED.
OBJECTIVE: To determine access to care among ED patients with asthma or hypertension and the association with sociodemographic factors and disease acuity.
METHODS: This was a prospective, cross-sectional study of ED patients at an urban county hospital conducted between June 4 and August 31, 2008. Consenting patients were surveyed, and peak flow or blood pressure measured as appropriate. Access to disease treatment was defined as self-reported access to a primary care provider or current prescription for asthma or hypertension, or both. Descriptive statistics and multinomial logistic regression were used to analyze data.
RESULTS: There were 2303 patients enrolled; 283 had asthma, 543 had hypertension, and 187 had both. Seventy-one patients (25.1%) with asthma, 151 patients (27.8%) with hypertension, and 19 patients (10.2%) with both had poor access to disease treatment. Seeking ED medical attention was related to having poor access to treatment for patients with both asthma and hypertension. Females with asthma had poor access to treatment. In hypertension patients, good access to treatment was associated with excellent/good health status, housing status, and decreasing age. Poor access to treatment was associated with increasing blood pressure.
CONCLUSIONS: Poor access to disease treatment and aspects of socioeconomic status were associated with seeking care in the ED. Changes in access to treatment may affect the number of patients seeking ED care, but not the severity of the presenting illness.
 

JEmergMed.2015Feb2.pii:S0736-4679(14)01337-7.doi:10.1016/j.jemermed.2014.12.015. [Epub ahead of print]