Manning W G, Wells K B
Department of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis 55455.
Med Care. 1992 Jun;30(6):541-53. doi: 10.1097/00005650-199206000-00007.
In this study, the authors determined whether mental health status affects the use of general medical services, with and without adjustment for the correlated effects of general health perceptions and physical health status on such use. Data were used from the RAND Health Insurance Experiment, which has information on up to 5 years of use of medical services by a nonelderly, civilian, general population. Health status and other covariates were assessed by self-administered questionnaires at enrollment. In the absence of statistical control for general and physical health status, worse mental health status-whether assessed by a global self-report measure or its two component parts, psychological well-being and psychological distress-significantly increased the use of both inpatient and outpatient general medical services. After controlling for general health perceptions, physical health status, demographic factors, and insurance plan coverage, the effects of mental health status on use are reduced, but not eliminated. Psychological distress and psychological well-being retained independent effects on total medical expenses.
在本研究中，作者确定了心理健康状况是否会影响常规医疗服务的使用，同时考虑了一般健康认知和身体健康状况对这种使用的相关影响，并进行了调整。数据来自兰德健康保险实验，该实验包含了非老年平民普通人群长达5年的医疗服务使用信息。在入组时通过自行填写问卷评估健康状况和其他协变量。在未对一般健康状况和身体健康状况进行统计控制的情况下，较差的心理健康状况——无论是通过整体自我报告测量还是其两个组成部分，即心理幸福感和心理困扰来评估——都会显著增加住院和门诊常规医疗服务的使用。在控制了一般健康认知、身体健康状况、人口统计学因素和保险计划覆盖范围后，心理健康状况对使用的影响有所降低，但并未消除。心理困扰和心理幸福感对总医疗费用仍有独立影响。
