多发性硬化症专业护理的可及性。
Access to multiple sclerosis specialty care.
机构信息
Department of Rehabilitation Medicine, Veterans Affairs Puget Sound Health Care System, S-117-RCS, 1660 S Columbian Way, Seattle, WA 98108; Multiple Sclerosis Center of Excellence West, Veterans Affairs, Seattle, WA; Department of Physical Medicine and Rehabilitation, University of Washington, Seattle, WA(∗).
Veterans Affairs Puget Sound Health Care System, Seattle, WA(†).
出版信息
PM R. 2013 Dec;5(12):1044-50. doi: 10.1016/j.pmrj.2013.07.009. Epub 2013 Aug 3.
BACKGROUND
Health care providers recommend an annual visit to a multiple sclerosis specialty care provider.
OBJECTIVE
To examine potential barriers to the implementation of this recommendation in the Veterans Health Administration.
DESIGN
Observational cohort study.
SETTING
Veterans Health Administration.
PARTICIPANTS
Participants were drawn from the Veterans Affairs Multiple Sclerosis National Data Repository and were included if they had an outpatient visit in 2007 and were alive in 2008 (N = 14,723).
MAIN OUTCOME MEASUREMENTS
Specialty care visit, receipt of medical services.
RESULTS
A total of 9643 (65.5%) participants had a specialty care visit in 2007. Veterans who were service connected, had greater medical comorbidity, and who lived in urban settings were more likely to have received a specialty care visit. Veterans who were older and had to travel greater distances to a center were less likely to have a specialty care visit.
CONCLUSIONS
Access to care in rural areas and areas at a greater distance from a major medical center represent notable barriers to rehabilitation and other multiple sclerosis-related care.
背景
医疗保健提供者建议多发性硬化症患者每年拜访一次多发性硬化症专科护理提供者。
目的
研究在退伍军人事务部中实施这一建议的潜在障碍。
设计
观察性队列研究。
设置
退伍军人事务部。
参与者
参与者来自退伍军人事务多发性硬化症国家数据存储库，如果他们在 2007 年有门诊就诊并且在 2008 年仍存活（N=14723），则被纳入研究。
主要观察指标
专科护理就诊、接受医疗服务。
结果
共有 9643 名（65.5%）参与者在 2007 年接受了专科护理就诊。与服务相关联、患有更多合并症且居住在城市地区的退伍军人更有可能接受专科护理就诊。年龄较大且前往中心的距离较远的退伍军人不太可能接受专科护理就诊。
结论
在农村地区和远离主要医疗中心的地区获得医疗服务是康复和其他多发性硬化症相关护理的显著障碍。
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