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美国国家健康访谈调查中的注意力缺陷多动障碍与医疗服务利用情况

ADHD and health services utilization in the national health interview survey.

作者信息

Cuffe Steven P, Moore Charity G, McKeown Robert

机构信息

Department of Psychiatry, University of Florida College of Medicine, Jacksonville, FL 32209, USA.

出版信息

J Atten Disord. 2009 Jan;12(4):330-40. doi: 10.1177/1087054708323248.

Abstract

OBJECTIVE

Describe the general health, comorbidities and health service use among U.S. children with ADHD.

METHOD

The 2001 National Health Interview Survey (NHIS) contained the Strengths and Difficulties Questionnaire (SDQ; used to determine probable ADHD), data on medical problems, overall health, and health care utilization.

RESULTS

Asthma was two and headaches were three times more prevalent, and overall health was significantly lower, among children with SDQ ADHD. Of children with SDQ ADHD, 45% saw a mental health professional in the past year and over half were not taking medication regularly. Urban residence, age (9-13), higher family education, having health insurance, and having comorbid emotional problems were associated with mental health care utilization in children with SDQ AD/HD, while race, gender and family income were not associated.

CONCLUSIONS

Children with SDQ AD/HD had more medical problems and were more likely to visit the emergency room. Treatment data suggest a problem with under-treatment of ADHD in the United States. Interventions should be targeted in rural areas, and among families with low education and without health insurance.

摘要

目的

描述美国患有注意力缺陷多动障碍(ADHD)儿童的总体健康状况、合并症及医疗服务利用情况。

方法

2001年全国健康访谈调查(NHIS)包含优势与困难问卷(SDQ,用于确定可能患有ADHD)、医疗问题、总体健康及医疗保健利用情况的数据。

结果

在SDQ确诊为ADHD的儿童中,哮喘患病率高出两倍,头痛患病率高出三倍,且总体健康状况明显较差。在SDQ确诊为ADHD的儿童中,45%在过去一年看过心理健康专业人员,超过一半未规律服药。城市居住、年龄(9 - 13岁)、较高的家庭教育水平、拥有健康保险以及存在合并的情绪问题与SDQ确诊为AD/HD儿童的心理健康服务利用相关,而种族、性别和家庭收入则无关联。

结论

SDQ确诊为AD/HD的儿童有更多医疗问题,且更有可能前往急诊室就诊。治疗数据表明美国存在ADHD治疗不足的问题。干预措施应针对农村地区以及教育程度低且无健康保险的家庭。

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