National Institutes of Health, Mark O. Hatfield Clinical Research Center, Rehabilitation Medicine Department, Building 10, CRC, Room 1-1469, 10 Center Drive, MSC 1604, Bethesda, MD 20892-1604, USA.
Health Serv Res. 2012 Apr;47(2):698-720. doi: 10.1111/j.1475-6773.2011.01346.x. Epub 2011 Nov 8.
To examine the disparity in delaying seeing a doctor due to cost between older adults with and without disabilities, and whether the disparity could be explained by health and financial variables.
Nationally representative sample of community-dwelling adults aged ≥65 who have health insurance and a usual source of care from the 2006 Behavioral Risk Factor Surveillance System (n = 85,015).
This cross-sectional study used sequential logistic regression models to examine the associations of delaying seeing a doctor due to cost with disability status, including demographic, health, and financial variables.
Older adults with disabilities had significantly higher odds of delaying seeing a doctor due to cost compared to older adults without disabilities after controlling for demographic, health, and financial factors. Although health and financial variables collectively attenuated the disparity, they did not fully explain the disparity.
Despite having health insurance and a usual source of care, older adults with disabilities encountered greater economic difficulties in seeing a doctor than their counterparts without disabilities. Policy makers should continue addressing the economic burden to improve timely visits to health care providers.
调查有残疾和无残疾的老年人因费用而延迟就医的差异，并分析健康和财务变量是否可以解释这种差异。
来自于 2006 年行为风险因素监测系统的具有医疗保险和常规医疗服务来源的、年龄在 65 岁及以上的社区居住成年人的全国代表性样本（n=85015）。
本横断面研究采用序贯逻辑回归模型，调查因费用而延迟就医与残疾状况的关联，包括人口统计学、健康和财务变量。
在控制人口统计学、健康和财务因素后，与无残疾的老年人相比，有残疾的老年人因费用而延迟就医的可能性显著更高。尽管健康和财务变量共同减弱了这种差异，但并未完全解释这种差异。
尽管有医疗保险和常规医疗服务来源，有残疾的老年人在就医方面遇到的经济困难比无残疾的老年人更大。政策制定者应继续解决经济负担问题，以改善及时就医的情况。
