Department of Medicine, Division of Neurology and Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada.
Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Neuroepidemiology. 2018;51(1-2):1-10. doi: 10.1159/000488799. Epub 2018 May 15.
Persons with multiple sclerosis (MS) use health resources with greater frequency than the general population. However, little is known regarding which patient characteristics might contribute.
The study aimed to evaluate characteristics associated with healthcare use in MS patients.
Consecutive MS clinic attendees were recruited (September-November 2010), with clinical, demographic, and patient-completed questionnaires collected at 3 visits over 2 years. Linkage with administrative data (hospital, physician, and pharmacy records) provided healthcare use outcomes until December 31, 2013. Findings were reported as adjusted rate ratios (adjRRs) using negative binomial regression.
A total of 340 MS patients with a mean (SD) age of 48.4 (12.0) years and subsequent follow-up of 3.1 (0.34) years were included. Fatigue and high physical comorbidity count (≥3 vs. none) were significantly associated with higher rates of physician encounters (adjRRs: 1.37 and 1.52, respectively), prescriptions filled (adjRRs: 1.25 and 1.40), and hospitalizations (adjRRs: 4.02 and 3.45). In addition, anxiety, disruptive pain, and perceived functional cognitive difficulties were associated with higher rates of physician encounters and prescriptions dispensed (adjRR ranged from 1.28 to 1.48).
The presence of fatigue and higher physical comorbidity burden were associated with higher rates of health services use. Findings have implications for those examining healthcare burden or organizing health services for persons with MS.
多发性硬化症（MS）患者比一般人群更频繁地使用医疗资源。然而，对于哪些患者特征可能导致这种情况，我们知之甚少。
本研究旨在评估与 MS 患者医疗保健使用相关的特征。
连续招募 MS 诊所就诊者（2010 年 9 月至 11 月），在 2 年内的 3 次就诊中收集临床、人口统计学和患者完成的问卷。与行政数据（医院、医生和药房记录）的链接提供了截至 2013 年 12 月 31 日的医疗保健使用结果。使用负二项回归报告调整后的比率比（adjRR）。
共纳入 340 名平均（SD）年龄为 48.4（12.0）岁的 MS 患者，随后随访 3.1（0.34）年。疲劳和高身体合并症计数（≥3 与无）与更高的医生就诊率（adjRR：1.37 和 1.52）、处方配药率（adjRR：1.25 和 1.40）和住院率（adjRR：4.02 和 3.45）显著相关。此外，焦虑、破坏性疼痛和感知到的功能性认知困难与更高的医生就诊率和处方配药率相关（adjRR 范围为 1.28 至 1.48）。
疲劳和更高的身体合并症负担与更高的医疗服务使用率相关。这些发现对那些检查医疗保健负担或为 MS 患者组织医疗服务的人具有重要意义。
