Division of Adolescent Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee 37232-9060, USA.
J Adolesc Health. 2010 May;46(5):407-13. doi: 10.1016/j.jadohealth.2009.09.010. Epub 2009 Nov 24.
To identify changes in ambulatory health care use during the transition from adolescence to young adulthood.
We analyzed data from health care encounters for adolescents (13-18 year olds) and young adults (19-24 year olds) in the National Ambulatory Medical Care Surveys or National Hospital Ambulatory Medical Care Surveys from 1997 through 2004. We present bivariate analysis of visit characteristics (including clinician specialty and health care setting, primary reason for the visit, and expected source of payment) for young adults as compared with those for adolescents, using weights provided by the National Center for Health Statistics to make national estimates.
Adolescents and young adults used similar number of health care visits annually; however, a greater proportion of ambulatory care for young adults was delivered in emergency departments as compared with adolescents (20% vs. 14%; p < .001), a smaller proportion was delivered to males (27% vs. 46%; p < .001), and a smaller proportion was covered by private health insurance (58% vs. 67%, respectively; p < .001). Among young adults, preventive care was listed as the reason for 40% of non-emergency department visits for females, whereas it accounted for only 10% of visits for males.
Significant changes in ambulatory health care use occur during young adulthood. Improving health care during the transition to adulthood will necessitate attention to health care research and delivery agendas that are relevant to the young adult population.
确定从青少年期向成年早期过渡期间，门诊医疗保健使用的变化情况。
我们分析了 1997 年至 2004 年期间全国门诊医疗保健调查或全国医院门诊医疗保健调查中青少年（13-18 岁）和年轻成年人（19-24 岁）的医疗保健就诊数据。我们对年轻成年人与青少年的就诊特征（包括临床医生的专业和医疗保健环境、就诊的主要原因和预期支付来源）进行了双变量分析，使用国家卫生统计中心提供的权重进行全国估计。
青少年和年轻成年人每年的门诊就诊次数相似；然而，与青少年相比，年轻成年人的更多门诊就诊是在急诊室进行的（20%对 14%；p<0.001），男性的比例较小（27%对 46%；p<0.001），私人健康保险的覆盖范围也较小（58%对 67%；p<0.001）。在年轻成年人中，预防保健被列为女性非急诊就诊的 40%，而男性仅占 10%。
在成年早期，门诊医疗保健的使用发生了重大变化。要改善向成年期过渡期间的医疗保健，就需要关注与年轻成年人相关的医疗保健研究和提供议程。
