Section and Research Unit of General Practice, Institute of Public Health, University of Copenhagen, Denmark.
BMC Geriatr. 2009 Sep 23;9:43. doi: 10.1186/1471-2318-9-43.
Subjective memory complaints (SMC) are common among elderly patients and little is know about the association between SMC and health care utilisation. Thus, the aim of this study was to investigate health care utilisation during a three-year follow-up among elderly patients consulting their general practitioner and reporting subjective memory complaints (SMC).
This study was conducted as a prospective cohort survey in general practice with three-year follow-up. Selected health care utilisation or costs relative to SMC adjusted for potential confounders were analyzed in a two-part model where the incidence of use of a selected health care service were analyzed separately from the quantity of use for those that use the service. The former analyzed in a Poisson regression approach, the latter in a generalized linear regression model.
A total 758 non-nursing home residents aged 65 years and older consulted their GP in October and November 2002 and participated in the present study. The adjusted probability of nursing home placement was significantly increased in subjects with SMC relative to subjects without SMC (RR = 2.3). More generally, SMC was associated with an increase in the cost of selected health care utilisation of 60% over three years (p = 0.003).
The data of this study indicated that in an elderly primary care population the presence of SMC increased the cost of health care utilisation by 60% over three years. Thus, inquiry into SMC may contribute to a risk profile assessment of elderly patients and may identify patients with an increased use of health care services.
主观记忆抱怨(SMC)在老年患者中很常见,但关于 SMC 与医疗保健利用之间的关系知之甚少。因此,本研究旨在调查在三年随访期间,向全科医生咨询并报告主观记忆抱怨(SMC)的老年患者的医疗保健利用情况。
本研究是在全科医学中进行的一项前瞻性队列研究,随访时间为三年。对调整潜在混杂因素后的 SMC 相关的特定医疗保健利用或成本进行两部分模型分析,其中一部分分析特定医疗保健服务的使用发生率,另一部分分析使用该服务的数量。前者采用泊松回归方法分析,后者采用广义线性回归模型分析。
共有 758 名年龄在 65 岁及以上、不在养老院居住的居民在 2002 年 10 月和 11 月咨询了他们的全科医生,并参加了本研究。与无 SMC 患者相比,SMC 患者入住养老院的概率显著增加(RR=2.3)。更一般地说,SMC 与三年内特定医疗保健利用成本增加 60%相关(p=0.003)。
本研究的数据表明,在老年初级保健人群中,SMC 的存在使三年内的医疗保健利用成本增加了 60%。因此,对 SMC 的调查可能有助于对老年患者的风险状况进行评估,并可能识别出对医疗保健服务利用增加的患者。