在诊断子宫内膜异位症之前和之后的卫生服务使用模式:数据链接前性队列研究
Gita D Mishra1, Dereje G Gete1, Mohammad R Baneshi1
1Australian Women and Girls' Health Research Centre, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Human reproduction (Oxford, England)
|February 22, 2025
概括
患有子宫内膜异位症的妇女在诊断前和诊断后使用更多的医疗保健服务,包括全科医生和专家访问. 诊断后,妇产科医生和诊断成像的访问增加,而其他专家的访问减少.
科学领域:
- 生殖健康 生殖健康
- 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:
- 与普通人群相比,患有子宫内膜异位症的女性的医疗保健利用率更高.
- 之前的研究缺乏纵向研究,检查医疗服务使用模式在子宫内膜异位症诊断之前和之后的长时间.
研究的目的:
- 调查女性在被诊断为子宫内膜异位症之前和之后使用卫生服务 (HSU) 的模式.
- 为了在长时间内比较患有子宫内膜异位症和没有子宫内膜异位症的女性之间的HSU模式.
主要方法:
- 利用来自澳大利亚妇女健康纵向研究的数据,与国家行政卫生记录 (1996-2021) 相联系.
- 包括两个队列 (1973-1978年和1989-1995年出生) 通过调查和健康记录确定了子宫内膜异位症病例,与对照对应.
- 采用随机拦截零膨胀负二项式模型来分析医疗保健服务使用情况,来自医疗保险福利计划数据库.
主要成果:
- 患有子宫内膜异位症的女性在诊断前和诊断后都显示出更高的全科医生 (GP),专家和诊断成像访问率.
- 在诊断之前,HSU在大约三年前达到峰值,然后在诊断后下降,但与对照组相比仍然升高.
- 诊断后,妇产科医生和诊断成像的访问增加,而与诊断前水平相比,全科医生和其他专家的访问减少.
结论:
- 患有子宫内膜异位症的女性在整个生命中都有更高和更明显的医疗保健需求,甚至在诊断后的几年.
- 了解这些HSU模式可以为改善子宫内膜异位症的诊断策略,临床管理和治疗结果提供信息.
- 这些发现突出了错误诊断的可能性,因为临床怀疑但未确认病例的比例很高,影响了研究和管理.
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