Palacio H, Shiboski C H, Yelin E H, Hessol N A, Greenblatt R M
AIDS Program at San Francisco General Hospital, Department of Medicine, University of California, San Francisco, School of Medicine, USA.
J Acquir Immune Defic Syndr. 1999 Aug 1;21(4):293-300. doi: 10.1097/00126334-199908010-00006.
To identify factors associated with the use of medical services, and to test a model of access to care, among HIV-infected women.
A cross-sectional telephone survey was administered to 213 HIV-infected women. Outcomes were having a primary care provider, and use of primary care and emergency health services. Predictors included characteristics of the population-at-risk and of the health care system.
Ninety-three percent of respondents had a primary care provider. Linear regression found age >45 years (p = .002), perceiving greater barriers to getting to a clinic (p = .04) and greater benefits from medications (p = .03), lack of problems with appointment times (p = .02), having AIDS (p = .01), shorter appointment waiting times (p = .0003), and greater cost of travel to care (p = .001) were associated with a greater number of primary care visits. Thirty-seven percent missed at least 1 primary care appointment. In logistic regression, lack of insurance (odds ratio [OR] = 2.76), current injection drug use (OR = 2.89) and difficulty remembering appointments (OR = 2.36) were associated with having missed any appointments.
Characteristics of the population-at-risk and of the health care system both make important contributions to primary care service use.
确定与医疗服务使用相关的因素，并在感染艾滋病毒的女性中测试一种获得医疗服务的模型。
对213名感染艾滋病毒的女性进行了横断面电话调查。结果包括是否有初级保健提供者，以及初级保健和急诊医疗服务的使用情况。预测因素包括高危人群和医疗保健系统的特征。
93%的受访者有初级保健提供者。线性回归发现，年龄>45岁（p = .002）、认为去诊所的障碍更大（p = .04）、从药物中获得的益处更大（p = .03）、预约时间没有问题（p = .02）、患有艾滋病（p = .01）、预约等待时间更短（p = .0003）以及前往就医的交通成本更高（p = .001）与更多的初级保健就诊次数相关。37%的人至少错过1次初级保健预约。在逻辑回归中，没有保险（比值比[OR]=2.76）、目前注射吸毒（OR = 2.89）和难以记住预约（OR = 2.36）与错过任何预约相关。
高危人群和医疗保健系统的特征都对初级保健服务的使用有重要影响。
