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社区居住的脊髓损伤患者对医疗保健服务的可及性和质量的满意度。

Satisfaction with access and quality of healthcare services for people with spinal cord injury living in the community.

机构信息

Swiss Paraplegic Research, Nottwil, Switzerland.

Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.

出版信息

J Spinal Cord Med. 2020 Jan;43(1):111-121. doi: 10.1080/10790268.2018.1486623. Epub 2018 Jul 2.

Abstract

To identify barriers to access healthcare services and reveal determinants of satisfaction with healthcare services in people with chronic spinal cord injury (SCI). Cross-sectional survey.: Community setting in Switzerland.: People with chronic SCI.: Non-applicable.: Questionnaire-based evaluation of availability and quality of healthcare services for secondary health conditions, satisfaction with fulfillment of healthcare needs, and preference for care from a hypothetical service provider with limited specialized SCI care expertise but in close proximity over comprehensive care from an existing specialized SCI center located at a greater distance. Close to three-quarter of participants (70%) indicated satisfaction with healthcare services received for SCI related health conditions. Elderly individuals (61+ years old) rated the availability and quality of healthcare 6% to 11% higher than younger individuals. The perceived fulfillment of healthcare needs was lower in people with incomplete paraplegia (odds ratio (OR) 2.11, 95%-credibility interval (CI) 1.18-3.84), chronic pain (OR 1.85, CI 1.12-3.08), insufficient access to long distance transportation (OR 5.81, CI 2.74-12.82), and longer travel distances to specialized SCI centers. Perceived inadequateness of access to healthcare services was partly related to transportation barriers, suggesting that outreach services or support with transportation are possible solutions. People with incomplete paralysis and pain consistently rated the fulfillment of care needs associated with SCI less favorably, pointing to the need for enhanced advocacy for this vulnerable groups.

摘要

为了确定慢性脊髓损伤(SCI)患者获得医疗服务的障碍,并揭示其对医疗服务满意度的决定因素。横断面调查。:瑞士社区环境。:慢性 SCI 患者。:不适用。:基于问卷的评估,评估二级健康状况的医疗服务的可及性和质量、对医疗需求满足程度的满意度,以及对假定服务提供者的偏好,该提供者的专业 SCI 护理知识有限,但距离较近,而不是现有专门的 SCI 中心的全面护理,该中心距离较远。近四分之三的参与者(70%)对接受的与 SCI 相关健康状况的医疗服务表示满意。老年人(61 岁以上)对医疗服务的可及性和质量的评价比年轻人高 6%至 11%。感知到的医疗需求满足程度在不完全性截瘫患者(比值比(OR)2.11,95%-可信度区间(CI)1.18-3.84)、慢性疼痛(OR 1.85,CI 1.12-3.08)、长途交通不便(OR 5.81,CI 2.74-12.82)和到专门的 SCI 中心的旅行距离较长的人群中较低。对医疗服务可及性的感知不足部分与交通障碍有关,这表明可以提供外展服务或交通支持。不完全瘫痪和疼痛的患者始终对与 SCI 相关的护理需求的满足程度评价较低,这表明需要为这一弱势群体提供更多的支持。

相似文献

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What determines low satisfaction with life in individuals with spinal cord injury?什么决定了脊髓损伤患者对生活的低满意度?
J Spinal Cord Med. 2019 Mar;42(2):236-244. doi: 10.1080/10790268.2018.1466480. Epub 2018 May 7.

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