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[德国60岁以上患者的医疗服务利用及药物摄入情况——与健康相关、与社会结构相关、社会人口统计学及主观因素]

[Utilization of medical services and medication intake of patients over 60 in Germany--health related, social structure related, socio-demographic and subjective factors].

作者信息

Hessel A, Gunzelmann T, Geyer M, Brähler E

机构信息

Universität Leipzig Klinik und Poliklinik für Psychotherapie und Psychosomatische Medizin.

出版信息

Z Gerontol Geriatr. 2000 Aug;33(4):289-99. doi: 10.1007/s003910070049.

DOI:10.1007/s003910070049
PMID:11028281
Abstract

In a community sample of 394 elderly aged 61 years and older from East and West Germany, diseases, contacts with general practitioners and specialists, the use of medicine, attitudes regarding health and illness, the subjective health, psychic problems, social support, social integration, social burden, and socio-demographic variables were assessed. Based on these data the determinants for the contact of physicians and the use of medicine were analyzed. The results confirmed the frequency of multimorbidity in the elderly; on average we found three different diseases at the same time for each person. In nearly 10% of the sample we found seven diagnoses existing at the same time. 88% had contact with a general practitioner at least once a year, 97% had contact either with a general practitioner or with a specialist once a year. 55.8% took at least one medicine each day. The number of diseases existing at the same time was the most determining variable for the contact of physicians and the use of medicine. Furthermore, the elderly had more contact with physicians and took more medicine if they thought they were susceptible to diseases in a high degree, and if they rated their own health as poor. Fewer contacts with physicians and a lower use of medicine were found in those elderly that rated health behavior as little useful, that had low control beliefs regarding their own health, and that experienced only a low degree of health-related limitations in their everyday life. Furthermore, we found a higher use of medicine if there was little social support. There were no significant age-related or sex-related differences regarding the contact of practitioners or the use of medicine.

摘要

在一项针对394名年龄在61岁及以上的东德和西德老年人的社区样本研究中,对疾病、与全科医生及专科医生的接触情况、药物使用情况、对健康和疾病的态度、主观健康状况、心理问题、社会支持、社会融入、社会负担以及社会人口统计学变量进行了评估。基于这些数据,分析了医生接触和药物使用的决定因素。结果证实了老年人中多病共存的频率;平均而言,我们发现每人同时患有三种不同的疾病。在近10%的样本中,我们发现同时存在七种诊断。88%的人每年至少与全科医生接触一次,97%的人每年与全科医生或专科医生接触一次。55.8%的人每天至少服用一种药物。同时存在的疾病数量是医生接触和药物使用的最具决定性的变量。此外,如果老年人认为自己极易患病,且对自身健康评价较差,那么他们与医生的接触就会更多,服用的药物也会更多。那些认为健康行为用处不大、对自身健康控制信念较低且在日常生活中仅经历低度健康相关限制的老年人,与医生的接触较少,药物使用也较少。此外,我们发现社会支持较少时药物使用会更多。在医生接触或药物使用方面,未发现与年龄或性别相关的显著差异。

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