Kennedy Jae, Rhodes Karin, Walls Craig A, Asplin Brent R
Department of Health Policy and Administration, Washington State University, Spokane, WA 99210-1495, USA.
Ann Emerg Med. 2004 May;43(5):567-73. doi: 10.1016/j.annemergmed.2003.10.012.
We monitor progress toward Healthy People 2010 objectives of reducing health disparities and decreasing delay and difficulty in access to emergency care.
This was a secondary analysis of 2001 National Health Interview Survey interviews of 33,326 adults to provide population-based estimates of self-reported delay, difficulty, or inability to get care from a hospital emergency department (ED) in the preceding 12 months.
About 7.7% of the estimated 36.6 million adults who sought care in a hospital ED in the preceding 12 months reported a delay in receiving care, having difficulty receiving care, or being unable to receive care. Waiting times were the most frequently noted cause of problems. Concerns about service costs and insurance coverage were also commonly cited access barriers. Access problems were more likely to be reported by adults without health insurance, younger adults, adults in fair or poor health, and adults with annual incomes of less than 20,000 dollars.
Self-reported access to ED care is impeded by prolonged waiting times and by cost and insurance coverage concerns. These access problems are occurring more frequently among groups that face multiple social and economic disadvantages. Hospital operational changes to reduce ED treatment delays and health care financing policies that reduce insurance coverage inequities may both be needed to meet these Healthy People 2010 objectives.
我们监测在实现《健康人民2010》中减少健康差异以及减少获得急诊护理的延迟和困难这两个目标方面取得的进展。
这是对2001年全国健康访谈调查中33326名成年人访谈的二次分析，以提供基于人群的在前12个月中自我报告的从医院急诊科获得护理的延迟、困难或无法获得护理情况的估计。
在估计的前12个月内在医院急诊科寻求护理的3660万成年人中，约7.7%报告在接受护理方面有延迟、接受护理有困难或无法获得护理。等待时间是最常被提及的问题原因。对服务费用和保险覆盖范围的担忧也常被列为获得护理的障碍。没有医疗保险的成年人、年轻人、健康状况一般或较差的成年人以及年收入低于20000美元的成年人更有可能报告获得护理存在问题。
自我报告的获得急诊护理受到长时间等待以及费用和保险覆盖范围担忧的阻碍。这些获得护理的问题在面临多种社会和经济劣势的群体中更频繁地出现。可能既需要医院运营方面的改变以减少急诊科治疗延迟，也需要医疗保健融资政策来减少保险覆盖范围的不平等，以实现《健康人民2010》的这些目标。
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