Adams Sally H, Park M Jane, Irwin Charles E
Division of Adolescent and Young Adult Medicine, University of California, San Francisco, San Francisco, California.
Division of Adolescent and Young Adult Medicine, University of California, San Francisco, San Francisco, California.
Am J Prev Med. 2015 Aug;49(2):238-47. doi: 10.1016/j.amepre.2015.02.022. Epub 2015 Apr 29.
The Affordable Care Act's preventive healthcare provisions have the potential to increase adolescents' and young adults' receipt of recommended preventive services. Assessing whether this potential is realized requires valid monitoring data in several areas, including receipt of an annual preventive visit. The purpose of this study is to describe and compare preventive visit rates across national surveys for adolescents and young adults.
This study, conducted in 2014: (1) identified national surveys with past-year preventive visit measures; (2) compared survey features, including mode of administration, respondent, response rate, demographic profile (univariate analysis), preventive visit measure wording, and method of construction; and (3) compared preventive visit rates, including rates among sociodemographic subgroups (bivariate analyses).
Four 2011 surveys were identified: National Health Interview Survey, National Survey of Children's Health (2011-2012), and Medical Expenditure Panel Survey (MEPS) for adolescents, and MEPS and Behavioral Risk Factor Surveillance System for young adults. Surveys varied by most assessed features; demographic profiles were similar. Preventive visit rates varied significantly across adolescents (43%-81%) and young adults (26%-58%). The largest differences in visit rates were in comparisons of subjective assessments to a more detailed assessment coded from specific records of visits kept by respondents. Sociodemographic differences in visit rates were consistent across surveys.
Further research is needed to assess reasons for the different estimates of preventive visits across national surveys. Those who monitor trends in receipt of recommended care for adolescents and young adults should take survey differences into account. Monitoring content of care is also needed.
《平价医疗法案》中的预防性医疗条款有可能增加青少年和年轻人接受推荐预防性服务的比例。要评估这一潜力是否得以实现,需要在多个领域获取有效的监测数据,包括年度预防性就诊情况。本研究的目的是描述和比较全国性调查中青少年和年轻人的预防性就诊率。
本研究于2014年开展:(1)确定过去一年有预防性就诊测量指标的全国性调查;(2)比较调查特征,包括实施方式、受访者、回复率、人口统计学概况(单变量分析)、预防性就诊测量指标的措辞以及构建方法;(3)比较预防性就诊率,包括社会人口学亚组中的比率(双变量分析)。
确定了四项2011年的调查:全国健康访谈调查、全国儿童健康调查(2011 - 2012年)以及针对青少年的医疗支出面板调查(MEPS),还有针对年轻人的MEPS和行为危险因素监测系统。各项调查在大多数评估特征上存在差异;人口统计学概况相似。青少年(43% - 81%)和年轻人(26% - 58%)的预防性就诊率差异显著。就诊率的最大差异在于主观评估与根据受访者保存的具体就诊记录编码得出的更详细评估之间的比较。不同调查中就诊率的社会人口学差异是一致的。
需要进一步研究以评估全国性调查中预防性就诊估计值不同的原因。监测青少年和年轻人接受推荐医疗服务趋势的人员应考虑调查差异。还需要监测医疗服务的内容。