ホームレスの人の医療利用に関連する要因
M B Kushel1, E Vittinghoff, J S Haas
1Division of General Internal Medicine, San Francisco General Hospital, Department of Medicine, Box 0936, University of California-San Francisco, San Francisco, CA 94143, USA. jhaas@itsa.ucsf.edu
JAMA
|February 15, 2001
まとめ
ホームレスの個人は,重要な医療の障壁に直面しています. 医療保険は, ambulatory care の利用の増加と障壁の減少と関連しており,病院への依存を潜在的に減らす可能性があります.
科学分野:
- 公衆衛生は公衆衛生である.
- 医療サービス 研究 医療サービス
- 健康の格差について
背景:
- ホームレスの人口は,深刻な健康問題に直面し,医療へのアクセスに多くの障害に直面しています.
- これまでの研究は,ホームレスの人々の医療利用に影響を及ぼす要因を全国的に包括的に調査していない.
研究 の 目的:
- ホームレスの人間の医療利用に関連する要因を特定する.
- この人口の中で,医療サービスを受けるための知覚された障壁を記述する.
主な方法:
- ホームレス支援プロバイダーとクライアントの全国調査からの二次データを活用しました.
- 米国全土の2974人のホームレスから得られた医療へのアクセスと利用に関する自己報告データを分析した.
- 外出医療,救急医療,入院医療の活用や,介護や医薬品の遵守における障壁について検討した.
主要な成果:
- 住居のない人の有意な割合は,必要な医療を受けられない (24.6%) と,処方薬の遵守に問題がある (32.1%) と報告しています.
- 医療保険は, ambulatory care (OR,2.54) と入院入院 (OR,2.60) の使用の増加と有意に関連していました.
- 医療保険を持つと,必要なケアへの障壁が少なくなる (OR,0.37) と,医薬品の服従が改善される (OR,0.35) と相関している.
結論:
- ホームレスの個人は,高い割合で医療の障壁に直面し,急性病院ベースのサービスに大きく依存しています.
- 医療保険は,ホームレスの人々のための健診医療へのアクセスを改善し,医療の障壁を減らすことに関連する重要な要因です.
- 医療保険の適用範囲を拡大することで,健康上の問題を緩和し,ホームレスの間で緊急の病院治療への依存を減らすことができます.
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