Beatty Phillip W, Hagglund Kristofer J, Neri Melinda T, Dhont Kelley R, Clark Mary J, Hilton Shelley A
National Rehabilitation Hospital Center for Health and Disability Research, Medstar Research Institute, Washington, DC, USA.
Arch Phys Med Rehabil. 2003 Oct;84(10):1417-25. doi: 10.1016/s0003-9993(03)00268-5.
To examine patterns of access to a variety of specific health care services among people with chronic or disabling conditions, focusing on factors that predict access to services.
National survey of 800 adults with cerebral palsy (CP), multiple sclerosis (MS), spinal cord injury (SCI), or arthritis.
Respondents were surveyed in the general community.
National convenience sample of adults with CP, MS, SCI, or arthritis.
Not applicable.
Access to services from primary care doctors, services from specialists, rehabilitative services, assistive equipment, and prescription medications. Cross tabulations and logistic regression analyses were performed on survey data to examine patterns and predictors of access to health care services.
Only half of all respondents received needed rehabilitative services. Respondents covered by fee-for-service health plans were more likely than those covered by managed care organizations to receive needed services from specialists. Respondents with the poorest health and with the lowest incomes were the least likely to receive all health services examined.
People with chronic or disabling conditions often require a comprehensive array of health care services. Reform of the current health care payment and delivery structures is needed so that health care is more responsive to those with the greatest service needs.
研究患有慢性疾病或残疾的人群获取各种特定医疗服务的模式，重点关注预测服务获取情况的因素。
对800名患有脑瘫（CP）、多发性硬化症（MS）、脊髓损伤（SCI）或关节炎的成年人进行全国性调查。
在普通社区对受访者进行调查。
患有CP、MS、SCI或关节炎的成年人的全国便利样本。
不适用。
获得初级保健医生的服务、专科医生的服务、康复服务、辅助设备和处方药。对调查数据进行交叉表分析和逻辑回归分析，以研究获取医疗服务的模式和预测因素。
所有受访者中只有一半获得了所需的康复服务。按服务收费的健康保险计划覆盖的受访者比管理式医疗组织覆盖的受访者更有可能从专科医生那里获得所需服务。健康状况最差和收入最低的受访者获得所有所调查医疗服务的可能性最小。
患有慢性疾病或残疾的人群通常需要一系列全面的医疗服务。需要对当前的医疗支付和提供结构进行改革，以使医疗服务对服务需求最大的人群更具响应性。
