在多发性硬化症中使用药物和健康资源的地理差异
Erin F Balcom1, Jennifer A McCombe1, Mahesh Kate1
1Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
概括
城市阿尔伯塔多发性硬化症 (pwMS) 患者获得的疾病修饰疗法 (DMT) 和专业护理比农村同行更多. 这突显了在MS护理的获取和利用方面城市/农村的差异.
科学领域:
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 了解多发性硬化症患者使用疾病修饰疗法 (DMT) 和医疗资源利用的地理差异对于识别和解决护理差距至关重要.
- 对pwMS的公平护理需要分析地理位置如何影响DMT和医疗保健服务的获取.
研究的目的:
- 为了比较阿尔伯塔省多发性硬化症 (pwMS) 患者的城市和农村人口之间的疾病修饰疗法 (DMT) 使用和医疗保健资源利用.
- 确定阿尔伯塔省多发性硬化症 (MS) 护理的潜在地理差异.
主要方法:
- 利用行政数据识别了阿尔伯塔省的pwMS队列,截至2017年4月1日.
- 通过简单的后勤回归来比较不同地理区域的DMT使用和医疗保健资源利用在两年后的指数日期.
主要成果:
- 与农村居民相比,城市地区的PwMS的DMT处方率 (32.3%对27.4%) 和访问专家,门诊护理和MS三级诊所的比例更高.
- 农村pwMS的DMT使用率和专业护理率较低,但急诊室访问率和住院率较高.
- 在阿尔伯塔省的健康区中观察到DMT选择和护理交付的变化,卡尔加里区显示出更多的门诊神经病学/多发性硬化症诊所.
结论:
- 对于阿尔伯塔省的pwMS来说,在DMT使用和医疗资源利用方面存在重大城市/农村不平等.
- 调查结果表明,需要探索DMT获取障碍和及时门诊MS护理的障碍,特别是在农村 pwMS.
- 建议为农村人口制定改善平等获得多发性硬化护理的战略.
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