Center for Management of Complex Chronic Care, Hines VA Hospital, Hines, IL 60141, USA.
Public Health. 2012 Oct;126(10):896-903. doi: 10.1016/j.puhe.2012.06.002. Epub 2012 Jul 15.
To understand preventive healthcare use by males with multiple sclerosis (MS).
Cross-sectional survey with secondary comparative data.
Primary survey data were collected from male veterans with MS (n = 1142) and compared with national surveillance data for a general veteran population (n = 31,500) and a general population (n = 68,357). Analyses compared use by group and identified variables associated with service use by male veterans with MS.
More veterans with MS had a cholesterol check (93%) than the general veteran population (89%, P < 0.001) and the general population (78%, P < 0.001). More veterans with MS had received annual influenza vaccination (69%) than the general veteran population (58%, P < 0.001) and the general population (42%, P < 0.001). More veterans with MS (81%) had ever received pneumonia vaccination than the general veteran population (67%) and the general population (51%) (P < 0.001). Colon screening was received by 55% of veterans with MS, 49% of the general veteran population (P < 0.001), and 39% of the general population (P < 0.0001). Fewer veterans with MS (34%) had received a prostate-specific antigen (PSA) test and digital rectal examination than the general veteran population (46%, P < 0.001) and the general population (36%, not significant). In males with MS, variables independently associated with cholesterol checks were: white race [odds ratio (OR) = 3.75] and living in the south (OR = 1.95); variables independently associated with influenza vaccination were increased age (OR = 1.03) and being a non-smoker (OR = 0.55); increased age was independently associated with colon screening (OR = 1.02); variables independently associated with PSA testing were increased age (OR = 1.08) and being employed (OR = 3.31), and being unemployed was independently associated with pneumonia vaccination (OR = 0.16).
More males with MS received several recommended preventive health services (e.g. cholesterol and colon screening, influenza and pneumonia vaccination) than males without MS. The Veterans Health Administration is meeting many prevention needs in males with MS, but there is room for improvement in areas such as reducing disparities in PSA screening and increasing respiratory vaccinations to meet national targets.
了解多发性硬化症（MS）男性患者的预防保健使用情况。
横断面调查及二次比较数据。
从患有 MS 的男性退伍军人（n=1142）中收集主要调查数据，并与全国退伍军人普通人群（n=31500）和普通人群（n=68357）的监测数据进行比较。分析比较了各组的使用情况，并确定了与男性 MS 退伍军人服务使用相关的变量。
与普通退伍军人人群（89%，P<0.001）和普通人群（78%，P<0.001）相比，更多的 MS 退伍军人接受了胆固醇检查（93%）。与普通退伍军人人群（58%，P<0.001）和普通人群（42%，P<0.001）相比，更多的 MS 退伍军人接受了年度流感疫苗接种。与普通退伍军人人群（67%）和普通人群（51%）相比，更多的 MS 退伍军人（81%）曾接受过肺炎疫苗接种（P<0.001）。有 55%的 MS 退伍军人接受了结肠癌筛查，49%的普通退伍军人人群（P<0.001）和 39%的普通人群（P<0.0001）。与普通退伍军人人群（46%，P<0.001）和普通人群（36%，无统计学意义）相比，较少的 MS 退伍军人（34%）接受了前列腺特异性抗原（PSA）检测和直肠指检。在 MS 男性患者中，与胆固醇检查相关的独立变量包括：白种人（优势比[OR]=3.75）和居住在南部（OR=1.95）；与流感疫苗接种相关的独立变量包括年龄增加（OR=1.03）和不吸烟（OR=0.55）；年龄增加与结肠癌筛查独立相关（OR=1.02）；与 PSA 检测相关的独立变量包括年龄增加（OR=1.08）和就业（OR=3.31），失业与肺炎疫苗接种独立相关（OR=0.16）。
与无 MS 的男性相比，更多的 MS 男性接受了几项推荐的预防保健服务（如胆固醇和结肠癌筛查、流感和肺炎疫苗接种）。退伍军人健康管理局满足了 MS 男性的许多预防需求，但在减少 PSA 筛查差异和增加呼吸道疫苗接种以达到国家目标等方面仍有改进空间。
