A118 THE IMPACT OF HOMELESSNESS ON ENDOSCOPY UTILIZATION, SURGICAL TREATMENT, AND POST-OPERATIVE COMPLICATIONS AMONG HOSPITALIZED PATIENTS WITH CROHN’S DISEASE
Notice bibliographique
Résumé
Abstract Background Homelessness is an important public health issue with a prevalence around 4.2% in the United States. Homelessness has been associated with lack of access to healthcare services, poor quality of care, and negative health outcomes. However, there is limited data on clinical outcomes among homeless individuals with Crohn’s disease (CD). Aims In this study, we examine inpatient outcomes including endoscopy utilization, surgical treatment, and post-operative complications among homeless patients with CD. Methods The Healthcare Utilization Project (HCUP) State Inpatient Databases from New York, Arizona, Massachusetts and Florida for 2013 and 2014 were used to identify adults ≥18 years admitted with CD identified by International Classification of Diseases, Ninth Revision codes. Homeless patients were then identified, and propensity score matched using a one-to-ten greedy nearest-neighbor approach to non-homeless patients to balance the distribution of baseline covariates. Differences in outcomes including endoscopy utilization, surgical treatment and post-operative complications were reported as odds ratios (ORs) and 95% confidence intervals (CI). Results A total of 70,457 CD hospitalizations were identified, of which 469 (0.6%) were associated with homelessness. We matched 440 homeless patients with 4,400 housed patients with CD. Homeless individuals had a higher proportion of males (p=0.002), tended to be older (p=0.035), and had more comorbidities than non-homeless individuals. There was no difference in mortality between non-homeless and homeless patients (OR 1.6, 95% CI 0.72-3.57). Endoscopy utilization was comparable between non-homeless and homeless patients with CD including gastroscopy (OR 0.71, 95% CI 0.40-1.18), colonoscopy (OR 0.80, 95% CI 0.31-1.69), and sigmoidoscopy (OR 0.37, 95% CI 0.02-1.74) [Figure 1]. Surgical treatment was also comparable, except for lower rates of bowel resection among homeless patients (OR 0.55, 95% CI: 0.29-0.93). The two groups also had similar rates of post-operative complications including pulmonary, cardiovascular, gastrointestinal, and infectious complications (Figure 1). Conclusions Homeless patients with CD have comparable endoscopy utilization and surgical treatment as non-homeless patients, except for lower bowel resection rates. Postoperative complications are also similar between the two groups. Future studies are needed to better understand the impact of homelessness on health outcomes and healthcare service utilization among patients with CD. Figure 1. Endoscopy utilization, surgical treatment, and post-operative complications among homeless and non-homeless individuals using 1:10 propensity matching Funding Agencies None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».