在患有抑郁症的医疗保险受益者中使用门诊护理
Evguenia Makovkina1, Joanna B Ringel2, Laura C Pinheiro2
1NewYork-Presbyterian Hospital, New York, New York, USA.
患有未经治疗的抑郁症的老年人不会过度使用医疗保健. 这项研究发现,他们的专家访问较少,护理较少分散,这表明精神病医疗服务的治疗不足和利用不足.
科学领域:
- 老年学是一门学科.
- 精神病学是一个精神病学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 抑郁症和医疗保健的使用,特别是门诊护理之间的关系,仍然不完全理解.
- 调查护理碎片化对于了解患者体验和医疗保健系统效率至关重要.
研究的目的:
- 检查老年人未经治疗的抑郁症和门诊护理利用模式之间的关联.
- 评估不同抑郁状态的老年人之间的护理分散程度.
主要方法:
- 使用与医疗保险索赔相关的"脑卒中地理和种族差异原因" (REGARDS) 研究数据的纵向研究 (N=1412).
- 参与者根据抑郁症状和抗抑郁药的使用被分为症状未治疗 (SU),症状治疗 (ST) 和无症状治疗 (AT) 组.
- 多变量逻辑回归用于分析研究小组与护理碎片化之间的关联 (反向Bice-Boxerman指数≥0.85).
主要成果:
- 与治疗组相比,症状未治疗 (SU) 组的专家访问较少.
- 与ST (10.7%) 和AT (11.9%) 组相比,SU参与者接受精神治疗的人数较少 (3.4%).
- 与ST组相比,SU组的高度分散护理几率明显较低 (aOR 0.68;95% CI 0.48-0.95).
结论:
- 患有未经治疗的抑郁症的老年人没有表现出过度寻求医疗保健.
- 调查结果表明,在初级保健机构中,抑郁症的治疗不足.
- 在未经治疗的抑郁症的老年人中,精神病医疗服务的利用率明显不足.
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