与无家可归者使用医疗保健相关的因素
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
概括
无家可归的人面临着严重的医疗保健障碍. 医疗保险与更多地使用门诊护理和更少的障碍有关,这可能会减少对医院的依赖.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 健康差异 在健康上的差异
背景情况:
- 无家可归的人群面临着重大的健康挑战,在获得医疗保健方面面临许多障碍.
- 之前的研究还没有全面研究影响无家可归者在全国范围内使用医疗保健的因素.
研究的目的:
- 确定与无家可归者使用医疗保健相关的因素.
- 描述在这个人群中获得医疗保健服务的感知障碍.
主要方法:
- 利用来自全国无家可归者援助提供者和客户调查的二次数据.
- 分析了来自美国各地2974名无家可归者的自我报告数据,这些数据涉及到医疗保健的获取和利用.
- 检查了门诊护理,急诊室,住院服务的使用情况,以及护理和药物合规性的障碍.
主要成果:
- 很大一部分无家可归者表示无法获得必要的医疗护理 (24.6%) 和难以遵守处方药的挑战 (32.1%).
- 医疗保险与更多地使用门诊护理 (OR,2.54) 和住院住院治疗 (OR,2.60) 有关.
- 拥有健康保险与报告所需护理障碍较少 (OR,0.37) 和改善药物服药 (OR,0.35) 相相关.
结论:
- 无家可归的人遇到高率的医疗保健障碍,并严重依赖急性医院服务.
- 医疗保险是一个关键因素,与改善门诊护理的准入和减少无家可归人口的医疗保健障碍有关.
- 扩大医疗保险覆盖范围可能会缓解健康问题,并减少无家可归者对紧急医院护理的依赖.
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