Gimm Gilbert, Wood Elizabeth, Zanwar Preeti
Department of Health Administration and Policy, George Mason University, Fairfax, VA.
Department of Health Policy and Administration, Washington State University, Spokane, WA.
Arch Phys Med Rehabil. 2017 Dec;98(12):2442-2448. doi: 10.1016/j.apmr.2017.05.017. Epub 2017 Jun 20.
To examine differences in access to preventive services for working-age adults with physical limitations, nonphysical limitations, and no limitations.
Observational data were pooled across calendar years 2003 through 2012 from the Medical Expenditure Panel Survey (MEPS), a nationally representative survey of noninstitutionalized U.S. adults.
Community.
Working-age adults (N=75,145; age range, 18-64y) who responded to all 5 rounds of the MEPS during 2003 through 2012.
Not applicable.
Blood pressure checks, flu shots, and dental visits, in the last 12 months.
Multivariate analyses showed that adults with physical limitations were more likely to receive a blood pressure check (92.2% vs 69.6%, respectively; P<.001) or flu shot (39.7% vs 23.4%, respectively; P<.001) than adults with no limitations. However, those with physical limitations were less likely to have a dental checkup (44.7% vs 59.4%, respectively; P<.001) than those with no limitation. Having a usual source of care increased the odds of receiving preventive services.
The study has implications for providers and policymakers. Policies that support the adequacy of provider networks and continuity with a usual source of care may increase the use of preventive services in adults with physical limitations.
研究有身体限制、无身体限制及无限制的适龄工作成年人在获得预防服务方面的差异。
观测数据汇总自2003年至2012年历年的医疗支出面板调查(MEPS),这是一项针对美国非机构化成年人的全国代表性调查。
社区。
2003年至2012年期间对MEPS的所有5轮调查都做出回应的适龄工作成年人(N = 75145;年龄范围18 - 64岁)。
不适用。
过去12个月内的血压检查、流感疫苗接种和牙科就诊情况。
多变量分析显示,有身体限制的成年人比无限制的成年人更有可能接受血压检查(分别为92.2%和69.6%;P <.001)或流感疫苗接种(分别为39.7%和23.4%;P <.001)。然而,有身体限制的成年人比无限制的成年人进行牙科检查的可能性更小(分别为44.7%和59.4%;P <.001)。有常规医疗服务来源会增加接受预防服务的几率。
该研究对医疗服务提供者和政策制定者具有启示意义。支持医疗服务提供者网络的充足性以及与常规医疗服务来源保持连续性的政策,可能会增加有身体限制的成年人对预防服务的使用。