Musich S, Ignaczak A, McDonald T, Hirschland D, Edington D W
Health Management Research Center, University of Michigan, Ann Arbor, Michigan 48104, USA.
J Am Geriatr Soc. 2001 Dec;49(12):1665-72.
Increased utilization of preventive services among the aging has been associated with improved health status and decreased medical costs. We sought to examine the use of the Health Risk Appraisal (HRA) in benchmarking compliance and characterizing those retired employees who met preventive service guidelines.
A retrospective cohort study of retired employees age 65 and older.
Nation-wide health promotion program offered by General Motors Corporation.
59,670 retired General Motors employees age 65 and older who participated in a nationwide mailed HRA health promotion program.
Preventive health services compliance was measured using selected HRA questions. Gender, HRA participation patterns, overall health risk status, medical plan selection and disease status were examined as predictors of increased compliance. Multivariate logistic regression models were developed to test the relative contributions of participant characteristics to increased utilization.
The self-reported HRA data indicated that compliance levels were higher than national averages. The Healthy People 2000 goals for the preventive services studied were met and exceeded (with the exception of tetanus immunization). Higher compliance was associated with being male, younger than 70 years, multiple-year HRA participation, overall low risk status and HMO insurance plan selection.
The results from the HRA indicated that this population participated at a higher level than a comparable national sample exceeding goals set by Healthy People 2000.
老年人预防性服务利用率的提高与健康状况改善及医疗成本降低相关。我们试图研究健康风险评估(HRA)在衡量依从性以及描述符合预防性服务指南的退休员工特征方面的应用。
对65岁及以上退休员工进行回顾性队列研究。
通用汽车公司提供的全国性健康促进项目。
59670名65岁及以上参与全国性邮寄HRA健康促进项目的通用汽车退休员工。
使用选定的HRA问题来衡量预防性健康服务的依从性。将性别、HRA参与模式、总体健康风险状况、医疗计划选择和疾病状况作为依从性提高的预测因素进行研究。建立多变量逻辑回归模型以测试参与者特征对利用率提高的相对贡献。
自我报告的HRA数据表明依从性水平高于全国平均水平。所研究的预防性服务达到并超过了《健康人民2000》的目标(破伤风免疫除外)。较高的依从性与男性、70岁以下、多年参与HRA、总体低风险状况和选择健康维护组织(HMO)保险计划相关。
HRA的结果表明,该人群的参与水平高于可比的全国样本,超过了《健康人民2000》设定的目标。