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老年医疗保险参保者的多种慢性病类型及就医倾向

Type of Multimorbidity and Propensity to Seek Care among Elderly Medicare.

作者信息

Garg Rahul, Shen Chan, Sambamoorthi Nethra, Sambamoorthim Usha

机构信息

West Virginia University.

University of Texas, MD Anderson Cancer Center.

出版信息

J Health Dispar Res Pract. 2017 Winter;10(4):34-51.

Abstract

Greater propensity to seek care is critical for improving health of elderly individuals with multimorbidity. We used the Medicare Current Beneficiary Survey (2012) to assess propensity to seek care among community-dwelling elderly Medicare beneficiaries (≥ 65 yrs.; =11,270) having (1) no physical or mental illness; (2) single physical or mental condition; (3) multimorbidity with physical conditions only; and (4) multimorbidity with both physical and mental conditions. As compared to multimorbidity with physical conditions, elderly with no multimorbidity were less likely (Adjusted Odds Ratio [95% CI]: 0.50 [0.36, 0.68]) and elderly with both physical and mental conditions were more likely (1.57 [1.28, 1.93]) to have a health problem for which they should have seen a doctor but did not. Further, elderly having a usual source of care were less likely (0.53 [0.37, 0.75]) to have a health problem for which they should have seen a doctor but did not. Multimorbidity is negatively associated with propensity to seek care. The presence of both chronic mental and physical conditions worsened propensity to seek care among elderly individuals. Future efforts to increase the awareness of receiving timely care and improve the access to care can enhance propensity to seek care among elderly individuals with multimorbidity.

摘要

更高的就医倾向对于改善患有多种疾病的老年人的健康状况至关重要。我们使用了医疗保险当前受益人调查(2012年)来评估社区居住的老年医疗保险受益人(≥65岁;n = 11,270)的就医倾向,这些受益人患有(1)无身体或精神疾病;(2)单一身体或精神疾病;(3)仅患有身体疾病的多种疾病;以及(4)患有身体和精神疾病的多种疾病。与仅患有身体疾病的多种疾病相比,无多种疾病的老年人出现本应就医但未就医的健康问题的可能性较小(调整后的优势比[95%置信区间]:0.50 [0.36, 0.68]),而患有身体和精神疾病的老年人出现此类情况的可能性较大(1.57 [1.28, 1.93])。此外,有常规医疗来源的老年人出现本应就医但未就医的健康问题的可能性较小(0.53 [0.37, 0.75])。多种疾病与就医倾向呈负相关。慢性身体和精神疾病的并存使老年人的就医倾向恶化。未来提高及时就医意识和改善就医机会的努力可以增强患有多种疾病的老年人的就医倾向。

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