Basalt Rehabilitation Center, the Hague, the Netherlands; Haaglanden Medical Center, the Hague, the Netherlands; Leiden University Medical Center, Leiden, the Netherlands.
Basalt Rehabilitation Center, Leiden, the Netherlands.
J Stroke Cerebrovasc Dis. 2019 Nov;28(11):104333. doi: 10.1016/j.jstrokecerebrovasdis.2019.104333. Epub 2019 Aug 24.
To describe health care use and its associated factors in the chronic phase after stroke.
Patients completed a questionnaire on health care use, 5-8 years after hospital admission for stroke. It comprised the number of visits to physicians or other health care professionals over the past 6 months (Physician-visits; Low ≤1 or High ≥2) and other health care professionals (Low = 0 or High ≥ 1). In addition the Longer-term Unmet Needs after Stroke (LUNS), Frenchay Activity Index (FAI) and Physical and Mental Component Summary Scales of the Short Form 12 (PCS and MCS) were administered. Their associations with health care use (high, low) were determined by means of logistic regression analysis, adjusted for sex and age.
Seventy-eight of 145 patients (54%) returned the questionnaires; mean time-since-stroke was 80.3 months (SD10.2), age-at-stroke 61.7 years (SD13.8), and 46 (59%) were male. Physician contacts concerned mainly the general practitioner (58; 79.5%). Forty-one (52.6%) and 37 (47.4%) of the patients had a high use of physician and other health professionals visits, respectively. Worse PCS scores were associated with both high use of physician and other health professionals visits (OR .931; 95%CI .877-.987 and OR .941; 95%CI .891-.993, respectively), whereas the FAI, MCS, or LUNS were not related to health care use.
Health care use after stroke is substantial and is related to physical aspects of health status, not to mental aspects, activities or unmet needs, suggesting a mismatch between patients' needs and care delivered.
描述中风后慢性期的医疗保健使用情况及其相关因素。
患者在中风住院后 5-8 年完成了一份关于医疗保健使用情况的问卷。它包括过去 6 个月内看医生或其他医疗保健专业人员的次数（医生就诊次数；低=1 或高≥2）和其他医疗保健专业人员（低=0 或高≥1）。此外，还进行了中风后长期未满足需求（LUNS）、Frenchay 活动指数（FAI）和简短 12 项健康调查量表的身体和精神成分综合评分量表（PCS 和 MCS）。通过逻辑回归分析，调整性别和年龄后，确定这些指标与医疗保健使用（高、低）的关系。
在 145 名患者中，有 78 名（54%）返回了问卷；中位随访时间为 80.3 个月（SD10.2），发病年龄为 61.7 岁（SD13.8），46 名（59%）为男性。医生就诊主要涉及全科医生（58；79.5%）。41 名（52.6%）和 37 名（47.4%）患者的医生就诊次数较高。PCS 评分较差与医生和其他卫生专业人员就诊次数较高均相关（OR.931；95%CI.877-.987 和 OR.941；95%CI.891-.993），而 FAI、MCS 或 LUNS 与医疗保健使用无关。
中风后医疗保健的使用量相当大，与健康状况的身体方面有关，而与心理健康、活动或未满足的需求无关，这表明患者的需求与提供的护理之间存在不匹配。
