Al Snih Soham, Markides Kyriakos S, Ray Laura A, Freeman Jean L, Ostir Glenn V, Goodwin James S
Department of Internal Medicine, Sealy Center on Aging, The University of Texas Medical Branch, Galveston, Texas 77555-0460, USA.
Ethn Dis. 2006 Summer;16(3):640-6.
To examine the effects of predisposing, enabling, and need factors on physician and hospital use among older Mexican Americans.
A two-year prospective cohort study.
Five Southwestern states: Texas, New Mexico, Colorado, Arizona, and California.
A population-based sample of 1987 non-institutionalized Mexican American men and women age > or =65 years.
Physician and hospital utilization. Predictor variables included predisposing, enabling, and need factors. Ordinary least square and logistic regression analysis were used to model the effects of predictor factors specified in the Andersen model of health service use on physician and hospital use.
After two years of follow-up, predisposing and enabling factors accounted for <5% of the variance in physician and hospital use. Need factors explained 21% of the variance in physician use and 7% of the variance in hospital use. Older age; being female; insurance coverage; having arthritis, diabetes, heart attack, hypertension, stroke, or cancer; and number of medications were factors associated with higher physician utilization. Subjects with arthritis, diabetes, hip fracture, high depressive symptoms, activities of daily living (ADL) disability, or high number of medications increased the odds of having any hospitalization. Subjects with diabetes, heart attack, hip fracture, ADL disabled, and high number of medications had a greater number of hospital nights than their counterparts.
Older age, female sex, insurance coverage, and prevalent medical conditions are determinants of healthcare use among older Mexican Americans.
研究易患因素、促成因素和需求因素对老年墨西哥裔美国人就医和住院情况的影响。
一项为期两年的前瞻性队列研究。
五个西南部州：得克萨斯州、新墨西哥州、科罗拉多州、亚利桑那州和加利福尼亚州。
基于人群的1987名年龄≥65岁的非机构化墨西哥裔美国男性和女性样本。
就医和住院情况。预测变量包括易患因素、促成因素和需求因素。采用普通最小二乘法和逻辑回归分析，对健康服务利用的安德森模型中指定的预测因素对就医和住院情况的影响进行建模。
经过两年的随访，易患因素和促成因素在就医和住院情况的差异中所占比例不到5%。需求因素解释了就医情况差异的21%和住院情况差异的7%。年龄较大、女性、有保险、患有关节炎、糖尿病、心脏病发作、高血压、中风或癌症以及用药数量是与较高就医率相关的因素。患有关节炎、糖尿病、髋部骨折、抑郁症状严重、日常生活活动（ADL）功能障碍或用药数量多的受试者住院的几率增加。患有糖尿病、心脏病发作、髋部骨折、ADL功能障碍和用药数量多的受试者的住院天数比其他人更多。
年龄较大、女性、有保险以及常见的医疗状况是老年墨西哥裔美国人医疗保健利用的决定因素。
