Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia (Ms Wang, Mr Palmer, Mr Otahal, Dr Sanderson); Monash Centre for Occupation and Environmental Health (MonCOEH), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia (Dr Cocker); and School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, UK (Dr Sanderson).
J Occup Environ Med. 2017 Aug;59(8):795-802. doi: 10.1097/JOM.0000000000001089.
The aim of this study was to understand the patterns of health care service utilization in employees with multimorbidity.
Data were obtained from the 2011 to 2012 cross-sectional Australian National Health Survey. Past-month health care service utilization was collected for each chronic condition from a pre-specified list. Descriptive, logistic, and Poisson regression analyses were used. The data were weighted to produce nationally representative estimates.
Multimorbid employees with arthritis had higher adjusted arthritis-specific general practitioner (GP) visit rates [rate ratio (RR) = 1.7, 95% confidence interval (95% CI) = 1.1 to 2.2, P < 0.001] than employees with arthritis alone. Similarly, multimorbid employees with cardiovascular disease (CVD) had higher adjusted CVD-specific specialist visit rates (RR = 1.6, 95% CI = 1.1 to 2.5, P < 0.05) and 2.5 times (95% CI = 1.5 to 4.0, P < 0.001) more CVD-specific other health professional visits than employees with CVD alone.
Given the increasing number of employees managing work and chronic illnesses, these findings have implications for health services and employers.
本研究旨在了解患有多种疾病的员工的医疗服务利用模式。
数据来自 2011 年至 2012 年的澳大利亚全国健康调查的横断面研究。从预先指定的清单中收集了每个慢性疾病的过去一个月的医疗服务利用情况。采用描述性、逻辑回归和泊松回归分析。对数据进行加权处理以产生具有全国代表性的估计值。
与仅患有关节炎的员工相比，患有关节炎的多种疾病的员工关节炎专科医生就诊率更高（调整后的比值比 [RR] = 1.7，95%置信区间 [95%CI] = 1.1 至 2.2，P < 0.001）。同样，患有心血管疾病 (CVD) 的多种疾病的员工 CVD 专科就诊率更高（RR = 1.6，95%CI = 1.1 至 2.5，P < 0.05），CVD 特定其他卫生专业人员就诊率也更高（RR = 2.5，95%CI = 1.5 至 4.0，P < 0.001）。
鉴于越来越多的员工既要工作又要管理慢性病，这些发现对卫生服务和雇主都具有重要意义。
