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国际收养儿童的医疗保健利用率增加。

Increased health-care utilisation in international adoptees.

作者信息

Graff Heidi J, Siersma Volkert D, Kragstrup Jakob, Petersson Birgit

机构信息

Department of Public Health, Section of General Practice, Unit of Women and Gender Research in Medicine, University of Copenhagen, P.O. Box 2099, 1014 Copenhagen, Denmark.

出版信息

Dan Med J. 2015 Aug;62(8):A5111.

Abstract

INTRODUCTION

Several studies have documented that international adoptees have an increased occurrence of health problems and contacts to the health-care system after arriving to their new country of residence. This may be explained by pre-adoption adversities, especially for the period immediately after adoption. Our study aimed to the assess health-care utilisation of international adoptees in primary and secondary care for somatic and psychiatric diagnoses in a late post-adoption period. Is there an increased use of the health-care system in this period, even when increased morbidity in the group of international adoptees is taken into consideration?

METHODS

This was a Danish register-based cohort study examining health-care utilisation in a multivariable two-part model. The prevalence of selected outcomes and the quantity of use were assessed in a late (year three, four and five) post-adoption period. The cohort comprised internationally adopted children (n = 6,820), adopted between 1994 and 2005, and all non-adopted children (n = 492,374) who could be matched with the adopted children on sex, age, municipality and family constellation at the time of adoption.

RESULTS

International adoption increased the use of all services in primary care, while in secondary care only few areas showed an increased long-term morbidity.

CONCLUSION

International adoptees use medical services in primary care at a higher rate than non-adoptees some years after adoption. Excess use of services in secondary care is also present, but only exists in selected areas.

FUNDING

none.

TRIAL REGISTRATION

not relevant.

摘要

引言

多项研究表明,国际收养儿童在抵达新居住国后,健康问题的发生率增加,与医疗保健系统的接触也增多。这可能是由于收养前的逆境,尤其是在收养后的 immediately 时期。我们的研究旨在评估国际收养儿童在收养后期在初级和二级医疗保健中对躯体和精神疾病诊断的医疗保健利用情况。即使考虑到国际收养儿童群体中发病率的增加,这一时期医疗保健系统的使用是否也会增加?

方法

这是一项基于丹麦登记册的队列研究,在多变量两部分模型中研究医疗保健利用情况。在收养后期(第三、四和五年)评估选定结局的患病率和使用量。该队列包括1994年至2005年间收养的国际收养儿童(n = 6,820),以及所有在收养时能够在性别、年龄、市镇和家庭构成方面与收养儿童匹配的非收养儿童(n = 492,374)。

结果

国际收养增加了初级保健中所有服务的使用,而在二级保健中,只有少数领域显示长期发病率增加。

结论

国际收养儿童在收养后几年使用初级保健医疗服务的比率高于非收养儿童。二级保健中也存在服务使用过度的情况,但仅存在于选定领域。

资金

无。

试验注册

不相关。

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