Golberstein Ezra, Liang Jersey, Quiñones Ana, Wolinsky Fredric D
University of Michigan School of Public Health, Ann Arbor, USA.
J Aging Health. 2007 Dec;19(6):888-906. doi: 10.1177/0898264307308338.
This research assesses the association of health services use with subsequent physical health among older Americans, adjusting for the confounding between health care use and prior health.
Longitudinal data are from the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD). Linear and logistic regressions are used to model the linkages between medical care use and health outcomes, including self-rated health, functional limitations, and mortality.
There is limited evidence that increased health care use is correlated with improved subsequent health. Increased use of medical care is largely associated with poorer health outcomes. Moreover, there are no significant interaction effects of health care use and baseline health on Activities of Daily Living and Instrumental Activities of Daily Living, despite the existence of a significant but very small interaction effect on self-rated health.
The findings have implications for the quality of care delivered by the American health care system.
本研究评估美国老年人健康服务利用与随后身体健康之间的关联,并对医疗保健利用与既往健康状况之间的混杂因素进行调整。
纵向数据来自最年长者资产与健康动态调查(AHEAD)。使用线性回归和逻辑回归对医疗保健利用与健康结果之间的联系进行建模,健康结果包括自评健康、功能受限和死亡率。
仅有有限的证据表明增加医疗保健利用与随后健康状况改善相关。医疗保健利用增加在很大程度上与较差的健康结果相关。此外,尽管在自评健康方面存在显著但非常小的交互作用,但医疗保健利用与基线健康状况对日常生活活动和工具性日常生活活动并无显著交互作用。
这些发现对美国医疗保健系统提供的护理质量具有启示意义。