Shen Chan, Sambamoorthi Usha
Department of Biostatistics, Universityof Texas, 1400 Pressler Street, Anderson Cancer Center, Houston, TX 77030, USA.
Women Health. 2012;52(1):1-17. doi: 10.1080/03630242.2011.641713.
The authors of this study examined the association between health-related quality of life and financial barriers to care, defined as not getting the needed care due to cost considerations. To better understand health-related quality of life among women veterans, the authors compared women veterans to women non-veterans. The authors conducted cross-sectional analyses using data from the 2009 Behavioral Risk Factor Surveillance System survey. The authors assessed four health-related quality of life measures: (1) general health; (2) physical health; (3) mental health; and (4) functional status. The authors performed multinomial logistic regressions to examine the relationship between financial barriers to receiving healthcare and health-related quality of life measures after controlling for other independent variables. The authors included women veterans not in active military duty (N = 3,747) and a matched sample of women non-veterans (N = 3,747), selected using a propensity score method so that they would have distributions of demographic and socioeconomic characteristics similar to those of the veterans. Overall, 14% of women reported financial barriers. Women who reported financial barriers to receiving healthcare were more likely to have poor health-related quality of life in all four dimensions than those who did not report such barriers. Compared to women non-veterans, women veterans did not differ in reported financial barriers but were more likely to report poor health-related quality of life. Reporting financial barriers to receiving needed healthcare was significantly associated with poor health-related quality of life among women. Veteran status was also significantly associated with poor health-related quality of life. These findings suggest the need for healthcare policy makers and practitioners to align emerging new models of healthcare delivery to improve health-related quality of life for women veterans.
本研究的作者考察了与健康相关的生活质量和医疗护理的经济障碍之间的关联，后者被定义为由于成本考量而未获得所需的护理。为了更好地了解女性退伍军人的与健康相关的生活质量，作者将女性退伍军人与非退伍女性进行了比较。作者利用2009年行为危险因素监测系统调查的数据进行了横断面分析。作者评估了四项与健康相关的生活质量指标：（1）总体健康；（2）身体健康；（3）心理健康；以及（4）功能状态。在控制了其他自变量之后，作者进行了多项逻辑回归分析，以考察接受医疗护理的经济障碍与与健康相关的生活质量指标之间的关系。作者纳入了未服现役的女性退伍军人（N = 3747）以及一个与之匹配的非退伍女性样本（N = 3747），该样本采用倾向得分法选取，以便其人口统计学和社会经济特征分布与退伍军人相似。总体而言，14%的女性报告存在经济障碍。报告在接受医疗护理方面存在经济障碍的女性在所有四个维度上的与健康相关的生活质量都比未报告此类障碍的女性更差。与非退伍女性相比，退伍女性在报告的经济障碍方面没有差异，但更有可能报告较差的与健康相关的生活质量。报告在接受所需医疗护理方面存在经济障碍与女性较差的与健康相关的生活质量显著相关。退伍军人身份也与较差的与健康相关的生活质量显著相关。这些发现表明，医疗保健政策制定者和从业者需要调整新出现的医疗服务模式，以改善女性退伍军人的与健康相关的生活质量。
