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残疾医疗补助受助人的抗抑郁药充足性和工作状况:基于限制的、倾向评分调整分析。

Antidepressant adequacy and work status among medicaid enrollees with disabilities: a restriction-based, propensity score-adjusted analysis.

机构信息

Center for Psychopharmacologic Research and Treatment, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.

出版信息

Community Ment Health J. 2009 Oct;45(5):333-40. doi: 10.1007/s10597-009-9199-2.

Abstract

Abstract This cross-sectional study of adult survey respondents with disability and depression (n = 199) enrolled in Massachusetts' Medicaid program examined the association of adequately or inadequately prescribed antidepressant treatment and self-reported work status using conditional logistic regression, controlling for age, gender, race, marital status, education, receipt of SSI/SSDI, self-reported disabling condition, and health status. Confounding by severity was addressed by two methods: restriction of our sample and subsequent stratification by propensity score. Individuals receiving adequate antidepressant treatment had an increased odds of working compared to individuals receiving inadequate treatment, both in analyses in which restriction was used to limit confounding (OR = 3.45, 95% CI = 1.15-10.32, P < .03), and in analyses which combined restriction with adjustment by propensity score stratification (OR = 3.04, 95% CI = 1.01-9.62, P < .05). Among this sample of Medicaid enrollees with disability and depression, those receiving adequate antidepressant treatment were significantly more likely to report working.

摘要

摘要 本研究采用横断面研究方法,对马萨诸塞州医疗补助计划中患有残疾和抑郁症的成年调查对象(n = 199)进行了调查,考察了充分或不充分处方抗抑郁药物治疗与自我报告工作状态之间的关联。通过条件逻辑回归,控制年龄、性别、种族、婚姻状况、教育程度、接受 SSI/SSDI、自我报告的残疾状况以及健康状况等因素,控制了混杂因素。通过两种方法解决了严重程度的混杂问题:限制我们的样本,并随后根据倾向评分进行分层。与接受不充分抗抑郁治疗的个体相比,接受充分抗抑郁治疗的个体工作的可能性更高,这两种分析方法均限制了混杂因素(OR = 3.45,95%CI = 1.15-10.32,P <.03),以及通过限制和调整倾向评分分层来结合的分析(OR = 3.04,95%CI = 1.01-9.62,P <.05)。在这项患有残疾和抑郁症的医疗补助计划参与者样本中,接受充分抗抑郁治疗的人更有可能报告工作。

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