Department of Family and Community Medicine, University of California at San Francisco, San Francisco, California, USA.
J Am Geriatr Soc. 2010 Dec;58(12):2416-22. doi: 10.1111/j.1532-5415.2010.03189.x.
This community-partnered study was developed and fielded in partnership with key community stakeholders and describes age- and race-related variation in delays in care and preventive service utilization between middle-aged and older adults living in South Los Angeles. The survey sample included adults aged 50 and older who self-identified as African American or Latino and lived in ZIP codes of South Los Angeles (N=708). Dependent variables were self-reported delays in care and use of preventive services. Insured participants aged 50 to 64 were more likely to report any delay in care (adjusted predicted percentage (APP)=18%, 95% confidence interval (CI)=14-23) and problems obtaining needed medical care (APP=15%, 95% CI=12-20) than those aged 65 and older. Uninsured participants aged 50 to 64 reported even greater delays in care (APP=45%, 95% CI=33-56) and problems obtaining needed medical (APP=33%, 95% CI=22-45) and specialty care (APP=26%, 95% CI=16-39) than those aged 65 and older. Participants aged 50 to 64 were generally less likely to receive preventive services, including influenza and pneumococcal vaccines and colonoscopy than older participants, but women were more likely to receive mammograms. Participants aged 50 to 64 had more problems obtaining recommended preventive care and faced more delays in care than those aged 65 and older, particularly if they were uninsured. Providing insurance coverage for this group may improve access to preventive care and promote wellness.
本社区合作研究是与关键的社区利益相关者合作开发和实施的，描述了居住在南洛杉矶的中老年人和老年人在医疗保健延迟和预防服务利用方面的年龄和种族差异。调查样本包括年龄在 50 岁及以上、自我认同为非裔美国人和拉丁裔、居住在南洛杉矶邮政编码（N=708）的成年人。因变量是自我报告的医疗保健延迟和预防服务的使用情况。有保险的 50 至 64 岁参与者比 65 岁及以上的参与者更有可能报告任何医疗保健延迟（调整后的预测百分比（APP）=18%，95%置信区间（CI）=14-23%）和获得所需医疗保健的问题（APP=15%，95%CI=12-20%）。50 至 64 岁的无保险参与者报告的医疗保健延迟甚至更大（APP=45%，95%CI=33-56%），获得所需医疗保健（APP=33%，95%CI=22-45%）和专科医疗保健（APP=26%，95%CI=16-39%）的问题也比 65 岁及以上的参与者多。与老年参与者相比，50 至 64 岁的参与者一般不太可能接受预防服务，包括流感和肺炎球菌疫苗和结肠镜检查，但女性更有可能接受乳房 X 光检查。50 至 64 岁的参与者在获得推荐的预防保健方面存在更多问题，并比 65 岁及以上的参与者面临更多的医疗保健延迟，特别是如果他们没有保险。为这一群体提供保险覆盖可能会改善获得预防保健的机会，并促进健康。
