Byrne Jacqueline H, Ware Robert S, Lennox Nicholas G
Aust J Prim Health. 2015;21(3):317-20. doi: 10.1071/PY14007.
People with intellectual disability experience inadequate health care and have unmet health needs that can go unidentified or be poorly managed. Health assessments have been shown to significantly increase short-term clinical activity for people with intellectual disability. The aim of this study was to more accurately quantify the effect of health assessments for people with intellectual disability by comparing health actions recorded in health assessment booklets to actions recorded in general practitioners' (GPs) records in the 12-month period following the health assessment. Participants were people with intellectual disability who had received a Comprehensive Health Assessment Program (CHAP), living in the community. The CHAP is a health assessment that is demonstrated to significantly increase health actions, compared with usual care, for people with intellectual disability. Data collected from three randomised controlled trials conducted in South-East Queensland, Australia, from 2000 to 2010 were pooled and analysed. The health assessment booklet contained significantly more information on health actions than GPs' records. Notably, hearing tests (risk ratio (RR) = 5.9; 95% confidence interval (CI) = 4.7-7.4), breast checks (RR = 3.9; 95% CI = 2.7-5.7), and skin examinations (RR = 7.9; 95% CI = 5.9-10.7) were more likely to be recorded in the CHAP booklet. Health assessments increase health actions for people with intellectual disability to a significantly greater extent than previously demonstrated.
智障人士获得的医疗保健不足,存在未得到满足的健康需求,这些需求可能未被识别或管理不善。健康评估已被证明能显著增加智障人士的短期临床活动。本研究的目的是通过比较健康评估手册中记录的健康行动与健康评估后12个月内全科医生(GP)记录中的行动,更准确地量化健康评估对智障人士的影响。参与者是居住在社区中接受过综合健康评估项目(CHAP)的智障人士。CHAP是一项健康评估,与常规护理相比,已证明能显著增加智障人士的健康行动。收集了2000年至2010年在澳大利亚昆士兰州东南部进行的三项随机对照试验的数据并进行分析。健康评估手册中包含的关于健康行动的信息比全科医生的记录显著更多。值得注意的是,听力测试(风险比(RR)=5.9;95%置信区间(CI)=4.7-7.4)、乳房检查(RR = 3.9;95% CI = 2.7-5.7)和皮肤检查(RR = 7.9;95% CI = 5.9-10.7)更有可能记录在CHAP手册中。健康评估比之前证明的更能显著增加智障人士的健康行动。