Scal Peter, Davern Michael, Ireland Marjorie, Park Kyong
Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN 55455, USA.
J Pediatr. 2008 Apr;152(4):471-5, 475.e1. doi: 10.1016/j.jpeds.2007.10.004. Epub 2008 Feb 20.
To examine the effect of the transition to adulthood on financial and non-financial barriers to care in youth with asthma.
With National Health Interview Survey data from 2000 to 2005, we examined delays and unmet needs because of financial and non-financial barriers, evaluating the effect of adolescent (age, 12-17 years; n = 1539) versus young adult age (age, 18-24 years; N = 833), controlling for insurance, usual source of care, and sociodemographic characteristics. We also simulated the effects of providing public insurance to uninsured patients and a usual source of care to patients without one.
More young adults than adolescents encountered financial barriers resulting in delays (18.6% versus 8%, P < .05) and unmet needs (26.6% versus 11.4%, P < .05), although delays caused by non-financial barriers were similar (17.3% versus 14.9%, P = not significant). In logistic models young adults were more likely than adolescents to report delays (odds ratio [OR], 1.45; 95% CI, 1.02-2.08) and unmet needs (OR, 1.8; 95% CI, 1.29-2.52) caused by financial barriers.
Delays and unmet needs for care caused by financial reasons are significantly higher for young adults than they are for adolescents with asthma.
探讨向成年期过渡对哮喘青少年获得医疗服务的经济和非经济障碍的影响。
利用2000年至2005年的国家健康访谈调查数据,我们研究了由于经济和非经济障碍导致的延误和未满足的需求,评估了青少年(年龄12 - 17岁;n = 1539)与青年成年人(年龄18 - 24岁;N = 833)的情况,并控制了保险、通常的医疗服务来源和社会人口学特征。我们还模拟了为未参保患者提供公共保险以及为没有固定医疗服务来源的患者提供固定医疗服务来源的效果。
与青少年相比,更多的青年成年人遇到经济障碍导致延误(18.6%对8%,P < 0.05)和未满足的需求(26.6%对11.4%,P < 0.05),尽管非经济障碍导致的延误相似(17.3%对14.9%,P = 无显著差异)。在逻辑模型中,青年成年人比青少年更有可能报告因经济障碍导致的延误(比值比[OR],1.45;95%置信区间,1.02 - 2.08)和未满足的需求(OR,1.8;95%置信区间,1.29 - 2.52)。
对于患有哮喘的青年成年人来说,因经济原因导致的医疗服务延误和未满足的需求显著高于青少年。