聋或重听青少年物质使用障碍相关急诊就诊后的住院和急性护理利用。
Hospitalization and acute care utilization after substance use disorder-related emergency department visits among deaf or hard of hearing youth.
文献信息
| PMID | 42829206 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Rie Sakai-Bizmark |
| 作者单位 | Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA; Department of Pediatrics, Harbor-UCLA Medical Center and the David Geffen School of Medicine, University of California at Los Angeles, Torrance, CA, USA. Electronic address: rsakaibizmark@lundquist.org. |
| 期刊 | Journal of substance use and addiction treatment |
| SCI 分区 | Q2 |
| IF | 2.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
引言： 听力损失青少年在急性护理环境中面临沟通障碍等挑战，并且物质使用风险增加。然而，听力损失与物质使用障碍（SUD）相关急诊科（ED）就诊后医疗保健利用之间的关联尚未被研究。
方法： 我们使用2016-2019年纽约州和马里兰州的州急诊科和州住院患者数据库进行了一项回顾性队列研究。识别了15-24岁有记录听力损失和SUD相关ED就诊的青少年。使用最近邻匹配构建了1:5倾向评分匹配队列，卡尺为倾向评分logit的0.2个标准差。使用带有医院水平随机截距的混合效应回归模型估计听力损失与ED就诊后住院、出院后30天内ED再访、住院时间、住院费用以及每日住院费用之间的关联。
结果： 队列包括287名有记录听力损失的青少年和1435名匹配的无记录听力损失同龄人。听力损失与更高的住院几率相关（调整比值比[aOR] 4.12；95% CI，2.78-6.10）。在住院青少年中，听力损失与更高的总住院费用相关（调整均值比[aMR] 1.18；95% CI，1.04-1.34），但与住院时间（aMR 1.11；95% CI，0.98-1.25）或30天ED再访（aOR 0.92；95% CI，0.63-1.33）无关。在主要分析中未观察到听力损失与每日费用之间的显著关联（aMR 1.08；95% CI，0.99-1.17），但几项敏感性分析提示听力损失青少年每日住院费用更高。
结论： 在2016-2019年纽约州和马里兰州有SUD相关ED就诊的青少年中，有记录听力损失与更高的住院几率和更高的总住院费用相关。此外，在几项敏感性分析中，听力损失与更高的每日住院费用相关。这些发现表明，听力损失青少年在ED就诊时或住院期间可能有更大的临床或护理协调需求。改善沟通可及性、支持早期SUD识别以及加强可及的门诊行为健康服务的策略可能有助于满足该人群的急性护理需求。
英文摘要
INTRODUCTION: Youth with hearing loss face challenges such as communication barriers in acute care settings and increased risk for substance use. Yet the association between hearing loss and healthcare utilization following substance use disorder (SUD)-related emergency department (ED) visits has not been examined.
METHODS: We conducted a retrospective cohort study using 2016-2019 State Emergency Department and State Inpatient Databases from New York and Maryland. Youth aged 15-24 with documented hearing loss and SUD-related ED visits were identified. A 1:5 propensity score-matched cohort was constructed using nearest-neighbor matching with a caliper of 0.2 standard deviations of the logit of the propensity score. Mixed-effects regression models with a hospital-level random intercept estimated associations between hearing loss and hospitalization following an ED visit, ED revisit within 30 days of discharge, inpatient length of stay, hospitalization costs, and hospitalization cost per day.
RESULTS: The cohort included 287 youths with documented hearing loss and 1435 matched peers without documented hearing loss. Hearing loss was associated with higher odds of hospitalization (adjusted odds ratio [aOR] 4.12; 95% CI, 2.78-6.10). Among hospitalized youth, hearing loss was associated with higher total hospitalization costs (adjusted mean ratio [aMR] 1.18; 95% CI, 1.04-1.34), but not length of stay (aMR 1.11; 95% CI, 0.98-1.25) or 30-day ED revisits (aOR 0.92; 95% CI, 0.63-1.33). No significant association between hearing loss and cost per day was observed in the primary analysis (aMR 1.08; 95% CI, 0.99-1.17), but several sensitivity analyses suggested higher cost per inpatient day among youth with hearing loss.
CONCLUSION: Among youth with SUD-related ED visits in New York and Maryland during 2016-2019, documented hearing loss was associated with higher odds of hospitalization and higher total hospitalization costs. In addition, hearing loss was associated with higher cost per inpatient day in several sensitivity analyses. These findings suggest that youth with hearing loss may have greater clinical or care coordination needs at ED presentation or during hospitalization. Strategies to improve communication access, support earlier SUD identification, and strengthen accessible outpatient behavioral health services may help address acute care needs in this population.