Beckerman H, van Zee I E, de Groot V, van den Bos G A M, Lankhorst G J, Dekker J
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Mult Scler. 2008 Nov;14(9):1269-79. doi: 10.1177/1352458508094884. Epub 2008 Jul 24.
This cross-sectional study investigates healthcare utilization, and determines which predisposing, enabling, and health factors are associated with healthcare utilization among 121 patients with multiple sclerosis (MS).
Data on patient-related predisposing, enabling, and health factors were collected by means of written questionnaires and a home visit from a well-trained physiotherapist.
Of the 121 patients with MS (mean age 43 years, mean score on the Expanded Disability Status Scale 3.5, disease duration 6 years), 16% were hospitalized in the previous year; 62% consulted their general practitioner, and 69% consulted their neurologist in the previous 6 months. Other medical specialists were consulted in the 6-month period by 50% of the study population. In a 4-week period preceding the home visit, 41% of the patients were treated by an allied healthcare professional. Multivariate logistic regression analyses showed that consulting the general practitioner, the neurologist, other medical specialists, and allied healthcare professionals, and the use of equipment/aids by MS patients is primarily related to their health, either as perceived by the patients themselves or defined by the professional.
MS patients in the Netherlands make appropriate use of healthcare facilities, because their utilization can predominantly be explained by health-related factors, and not by predisposing or enabling factors.
本横断面研究调查了医疗保健利用情况，并确定了121例多发性硬化症（MS）患者中哪些 predisposing、促成和健康因素与医疗保健利用相关。
通过书面问卷以及由训练有素的物理治疗师进行家访来收集与患者相关的predisposing、促成和健康因素的数据。
在121例MS患者中（平均年龄43岁，扩展残疾状态量表平均得分3.5，病程6年），16%的患者在上一年住院；62%的患者在过去6个月中咨询过他们的全科医生，69%的患者咨询过他们的神经科医生。50%的研究人群在6个月内还咨询过其他医学专家。在家访前的4周内，41%的患者接受过联合医疗保健专业人员的治疗。多变量逻辑回归分析表明，咨询全科医生、神经科医生、其他医学专家和联合医疗保健专业人员，以及MS患者使用设备/辅助器具，主要与他们自身感知或专业人员界定的健康状况有关。
荷兰的MS患者适当利用了医疗保健设施，因为他们的利用情况主要可以由与健康相关的因素来解释，而不是由predisposing或促成因素来解释。
