Maaten Sarah, Kephart George, Kirkland Susan, Andreou Pantelis
Elgin St, Thomas Public Health, 99 Edward St,, St Thomas, Ontario N5P 1Y8, Canada.
BMC Health Serv Res. 2008 Nov 15;8:237. doi: 10.1186/1472-6963-8-237.
To examine the association between number and combination of chronic disease risk factors on health service use.
Data from the 1995 Nova Scotia Health Survey (n = 2,653) was linked to provincial health services administrative databases. Multivariate regression models were developed that included important interactions between risk factors and were stratified by sex and at age 50. Negative-binomial regression models were estimated using generalized estimating equations assuming an autoregressive covariance structure.
As the number of chronic disease risk factors increased so did the number of annual general practitioner visits, specialist visits and days spent in hospital in people aged 50 and older. This was not seen among individuals under age 50. Comparison of smokers, people with high blood pressure and people with high cholesterol showed no significantly different impact on health service use.
As the number of chronic disease risk factors increased so did health service use among individuals over age 50 but risk factor combination had no impact.
研究慢性病风险因素的数量及组合与医疗服务使用之间的关联。
1995年新斯科舍省健康调查（n = 2653）的数据与省级医疗服务管理数据库相链接。构建了多变量回归模型，其中包括风险因素之间的重要交互作用，并按性别和50岁进行分层。使用广义估计方程估计负二项回归模型，假定为自回归协方差结构。
在50岁及以上人群中，随着慢性病风险因素数量的增加，每年看全科医生的次数、看专科医生的次数以及住院天数均增加。50岁以下人群未出现这种情况。吸烟者、高血压患者和高胆固醇患者之间的比较显示，对医疗服务使用的影响无显著差异。
在50岁以上人群中，随着慢性病风险因素数量的增加，医疗服务使用也增加，但风险因素组合没有影响。
