Okoro Catherine A, Strine Tara W, Young Stacy L, Balluz Lina S, Mokdad Ali H
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease, Control and Prevention, Atlanta, GA 30341, USA.
Prev Med. 2005 Mar;40(3):337-43. doi: 10.1016/j.ypmed.2004.06.009.
Although most of the 34 million U.S. adults aged 65 years and older have health care coverage, many do not receive preventive care. To investigate why, we examined various barriers to access of health care and their effect on obtaining preventive care.
A cross-sectional study was conducted of noninstitutionalized adults, aged 65 years or older, in states that participated in the Behavioral Risk Factor Surveillance System in 2002.
Of the 46,659 respondents aged 65 years and older, 93% had a regular care provider, 98% had a regular place of care, and 98% were able to obtain needed medical care. Those with a regular care provider or a regular place of care were more likely to receive clinical preventive services than those without either of these. Reasons for not obtaining needed medical care were cost (27%), too long a wait for an appointment (20%), no transportation or distance (9%), office not open when the individual could get there (8%), and other reasons (32%).
Having a regular care provider or a regular place of care is associated with a significant likelihood of receipt of clinical preventive services among older adults. Efforts to eliminate barriers to health care access may increase older adults' receipt of such services.
尽管美国3400万65岁及以上的成年人中大多数都有医保，但许多人并未接受预防性保健服务。为探究其原因，我们研究了获取医疗保健的各种障碍及其对获得预防性保健服务的影响。
对2002年参与行为危险因素监测系统的各州65岁及以上的非机构化成年人进行了一项横断面研究。
在46659名65岁及以上的受访者中，93%有固定的医疗服务提供者，98%有固定的就医地点，98%能够获得所需的医疗服务。有固定医疗服务提供者或固定就医地点的人比没有这两者的人更有可能接受临床预防性服务。未获得所需医疗服务的原因包括费用（27%）、等待预约时间过长（20%）、没有交通工具或距离远（9%）、个人能前往就医时诊所不营业（8%）以及其他原因（32%）。
有固定的医疗服务提供者或固定的就医地点与老年人接受临床预防性服务的可能性显著相关。消除获取医疗保健障碍的努力可能会增加老年人获得此类服务的比例。
