Iron Karey S, Manuel Douglas G, Williams Jack
Institute for Clinical Evaluative Sciences, G 106, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5.
Chronic Dis Can. 2003 Fall;24(4):124-32.
Evidence-based health care planning for persons with chronic conditions is difficult. Routinely collected data are not specific enough to obtain prevalence estimates for chronic conditions and accompanying health determinants, whereas available survey data do not provide accurate utilization and/or cost information. The purpose of this study was to determine the association of self- reported demographic factors (age, sex), access (having a regular doctor), socio-economic factors (education/income) and need (comorbidity) with actual family physician costs for persons with arthritis/rheumatism, asthma, back pain, high blood pressure and migraines. Data from consenting Ontario respondents to the 1994 Canadian National Population Health Survey were linked with provincial physician billing claims. More than half of Ontario adults aged 25 and over reported a chronic condition; 24% reported two or more. Age, sex, access, socio-economic status and need were independently associated with family practice utilization and costs, and the magnitude of the effects varied by condition. Linked survey/administrative data can provide valuable information to assist in evidence-based health care planning.
为慢性病患者制定循证医疗保健计划颇具难度。常规收集的数据不够具体，无法获取慢性病及其相关健康决定因素的患病率估计值，而现有的调查数据又无法提供准确的医疗服务利用情况和/或成本信息。本研究旨在确定自我报告的人口统计学因素（年龄、性别）、就医渠道（有固定医生）、社会经济因素（教育程度/收入）和需求（合并症）与关节炎/风湿病、哮喘、背痛、高血压和偏头痛患者实际家庭医生费用之间的关联。安大略省1994年加拿大全国人口健康调查的同意参与的受访者数据与省级医生计费索赔数据相链接。安大略省25岁及以上的成年人中，超过一半报告患有慢性病；24%报告患有两种或更多慢性病。年龄、性别、就医渠道、社会经济地位和需求与家庭医疗服务利用和费用独立相关，且影响程度因疾病而异。链接的调查/行政数据可为循证医疗保健计划提供有价值的信息。
