Guzman Jenice S, Sohn Linda, Harada Nancy D
Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, and School of Nursing, University of Califorinia at Los Angeles, 90073, USA.
J Am Geriatr Soc. 2004 Apr;52(4):617-22. doi: 10.1111/j.1532-5415.2004.52172.x.
In nonveteran older adults, living alone influences outpatient care use, but its importance in the veteran population has not been well studied. The aims of this study are to describe the use of outpatient care by older veterans who live alone versus those who live with others and determine whether living alone influences outpatient use by older veterans. The data come from the 2001 Veteran Identity Program Survey designed to measure Department of Veterans Affairs (VA) and non-VA outpatient care use. Univariate and bivariate analyses were conducted to examine distributional properties, associations, and subgroup differences in outpatient care use. Poisson regression was used to assess the role of living alone on outpatient care use, controlling for predisposing, other enabling, and need factors. Results found that older veterans who use the VA, whether they live alone or not, have similar numbers of VA outpatient visits. Older veterans who use VA and non-VA facilities and who live alone have greater total outpatient visits than those who live with others. Regression results indicate that living alone is a predictor of VA routine medical visits, VA prescription refill visits, and total VA and non-VA outpatient visits but does not influence VA emergency room visits. These findings suggest that living alone is associated with differences in outpatient care use by older veterans. It is important for the VA to understand this relationship with the aim of developing interventions to improve access, effectiveness, and efficiency of health services for older veterans.
在非退伍军人的老年人中，独居会影响门诊医疗服务的使用，但它在退伍军人中的重要性尚未得到充分研究。本研究的目的是描述独居的老年退伍军人与与他人同住的老年退伍军人的门诊医疗服务使用情况，并确定独居是否会影响老年退伍军人的门诊医疗服务使用。数据来自2001年退伍军人身份计划调查，该调查旨在衡量退伍军人事务部（VA）和非VA门诊医疗服务的使用情况。进行了单变量和双变量分析，以检查门诊医疗服务使用的分布特性、关联和亚组差异。使用泊松回归来评估独居在门诊医疗服务使用中的作用，同时控制 predisposing、其他促成因素和需求因素。结果发现，使用VA的老年退伍军人，无论他们是否独居，VA门诊就诊次数相似。使用VA和非VA设施且独居的老年退伍军人的门诊就诊总次数比与他人同住的退伍军人更多。回归结果表明，独居是VA常规医疗就诊、VA处方续签就诊以及VA和非VA门诊就诊总数的一个预测因素，但不影响VA急诊室就诊。这些发现表明，独居与老年退伍军人门诊医疗服务使用的差异有关。对于VA来说，了解这种关系对于制定干预措施以改善老年退伍军人获得医疗服务的机会、有效性和效率至关重要。
