Fialho Camila Bruno, Lima-Costa Maria Fernanda, Giacomin Karla Cristina, Loyola Filho Antônio Ignácio de
Cad Saude Publica. 2014 Mar;30(3):599-610. doi: 10.1590/0102-311x00090913.
This study focused on the association between disability and use of health services among elderly individuals in Greater Metropolitan Belo Horizonte, Minas Gerais State, Brazil. The study included 1,624 elderly patients (≥ 60 years) selected by representative sampling. The dependent variable was use of health services, based on three descriptors: number of physician visits, home consultations, and hospitalizations. The target independent variable was disability, including difficulty in performing activities of daily living (ADL) and instrumental activities of daily living (IADL). IADL was only associated with hospitalization (PR = 1.62; 95%CI: 1.16-2.26), while ADL was associated with hospitalization (PR = 1.73; 95%CI: 1.24-2.42) and home consultations (PR = 8.54; 95%CI: 4.22-17.27). The findings show increased use of health services (especially more costly ones) among older adults with disabilities, and that functional health dimensions have not oriented health services, still largely conditioned on the presence of diseases.
本研究聚焦于巴西米纳斯吉拉斯州大贝洛奥里藏特都会区老年人的残疾状况与卫生服务利用之间的关联。该研究通过代表性抽样选取了1624名老年患者（≥60岁）。因变量是卫生服务利用情况，基于三个描述指标：看医生次数、家庭会诊次数和住院次数。目标自变量是残疾状况，包括日常生活活动（ADL）困难和工具性日常生活活动（IADL）困难。IADL仅与住院相关（风险比PR = 1.62；95%置信区间CI：1.16 - 2.26），而ADL与住院（PR = 1.73；95%CI：1.24 - 2.42）和家庭会诊相关（PR = 8.54；95%CI：4.22 - 17.27）。研究结果表明，残疾老年人对卫生服务（尤其是费用更高的服务）的利用增加，而且功能健康维度并未指导卫生服务，卫生服务很大程度上仍受疾病存在情况的制约。
