Lyles Emily, Burnham Gilbert, Chlela Lara, Spiegel Paul, Morlock Laura, Doocy Shannon
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205 USA.
Médecins du Monde, Beirut, Lebanon.
J Diabetes Metab Disord. 2020 Sep 18;19(2):1245-1259. doi: 10.1007/s40200-020-00638-6. eCollection 2020 Dec.
This study uses data from a 2015 household survey of Syrian refugees and Lebanese host communities. A total of 1,376 refugee and 686 host community households were surveyed using a cluster design with probability proportional to size sampling. Differences in outcomes of interest by population group were examined using Pearson's chi-square and t-test methods and the crude and adjusted odds of care-seeking and interrupted medication adherence among Syrian refugees were estimated using logistic regression.
Findings identified significant gaps between refugees and host community members in care-seeking, health facility utilization, out-of-pocket payments for care, and medication interruption. While host community members had better access to care and fewer reports of medication interruption compared to refugees, out-of-pocket spending for the most recent care visit was significantly higher among host community care-seekers. Refugee care-seekers most frequently received care at primary health facilities, choosing to do so mainly for reasons related to cost, whereas host community care-seekers predominantly utilized private clinics with greater concern for quality and continuity of care.
Further efforts are needed to facilitate lower and more predictable health service costs for refugees and vulnerable host community members, as is continued communication on available subsidized care.
To characterize care-seeking, health service utilization and spending, and medication prescribing and adherence for hypertension and diabetes among Syrian refugees and host communities in Lebanon.
本研究使用了2015年对叙利亚难民和黎巴嫩收容社区进行的家庭调查数据。采用与规模成比例的概率抽样整群设计，对总共1376户难民家庭和686户收容社区家庭进行了调查。使用Pearson卡方检验和t检验方法检验不同人群在感兴趣的结果方面的差异，并使用逻辑回归估计叙利亚难民寻求医疗服务和中断药物依从性的粗略和调整后的比值比。
研究结果表明，难民和收容社区成员在寻求医疗服务、卫生设施利用、医疗自费支付以及药物中断方面存在显著差距。与难民相比，收容社区成员获得医疗服务的机会更好，药物中断的报告更少，但收容社区寻求医疗服务者最近一次就诊的自费支出显著更高。难民寻求医疗服务者最常在初级卫生设施接受治疗，主要是出于成本相关原因而选择这样做，而收容社区寻求医疗服务者则主要利用私人诊所，更关注医疗质量和连续性。
需要进一步努力，为难民和脆弱的收容社区成员降低医疗服务成本并使其更具可预测性，同时继续就现有的补贴医疗服务进行沟通。
描述黎巴嫩叙利亚难民和收容社区中高血压和糖尿病患者的就医行为、医疗服务利用和支出情况，以及药物处方和依从性。
