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加拿大情绪障碍诊断与未满足的医疗保健需求之间的关系:2014年加拿大社区健康调查的结果

The relationship between mood disorder diagnosis and experiencing an unmet health-care need in Canada: findings from the 2014 Canadian Community Health Survey.

作者信息

McLeod Katherine E, Karim Mohammad Ehsanul

机构信息

Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.

Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, Vancouver, BC, Canada.

出版信息

J Ment Health. 2023 Feb;32(1):11-23. doi: 10.1080/09638237.2020.1818192. Epub 2020 Sep 24.

DOI:10.1080/09638237.2020.1818192
PMID:32967489
Abstract

BACKGROUND

Despite Canada's universal health-care system, millions of Canadians experience unmet health-care needs (UHCN). People with mood disorders may be at higher risk of UHCN due to barriers such as stigma and gaps in health-care services.

AIM

We aimed to examine the relationship between having a diagnosed mood disorder and experiencing UHCN using a recent, nationally representative survey.

METHODS

Using the 2014 Canadian Community Health Survey, we used multivariate logistic regression to estimate the association between mood disorder and UHCN in the past 12 months, adjusting for sociodemographic variables and health status.

RESULTS

Among 52,825 respondents, 11.8% reported UHCN. Respondents with a diagnosed mood disorder were more likely to report UHCN [adjusted odds ratio (OR) 1.61, 95% confidence interval (CI) 1.38, 1.89]. Among respondents with a regular doctor, people with mood disorders were still more likely to report UHCN (OR 1.63, 95% CI 1.38, 1.93). Sensitivity analyses using propensity score and missing data imputation approaches resulted in similar estimates.

CONCLUSIONS

Adults diagnosed with a mood disorder are more likely to report UHCN in the past year, even those with a regular doctor. Our findings suggest that barriers beyond physician attachment may impact access to care for people with mood disorders.

摘要

背景

尽管加拿大拥有全民医疗保健系统,但仍有数百万人存在未满足的医疗保健需求(UHCN)。由于耻辱感和医疗服务差距等障碍,患有情绪障碍的人可能面临更高的未满足医疗保健需求风险。

目的

我们旨在通过一项近期具有全国代表性的调查,研究被诊断患有情绪障碍与经历未满足医疗保健需求之间的关系。

方法

利用2014年加拿大社区健康调查,我们使用多变量逻辑回归来估计过去12个月中情绪障碍与未满足医疗保健需求之间的关联,并对社会人口统计学变量和健康状况进行了调整。

结果

在52825名受访者中,11.8%的人报告存在未满足医疗保健需求。被诊断患有情绪障碍的受访者更有可能报告未满足医疗保健需求[调整后的优势比(OR)为1.61,95%置信区间(CI)为1.38,1.89]。在有固定医生的受访者中,患有情绪障碍的人仍然更有可能报告未满足医疗保健需求(OR为1.63,95%CI为1.38,1.93)。使用倾向评分和缺失数据插补方法进行的敏感性分析得出了类似的估计结果。

结论

被诊断患有情绪障碍的成年人在过去一年中更有可能报告未满足医疗保健需求,即使是那些有固定医生的人。我们的研究结果表明,除了与医生的联系之外,其他障碍可能会影响情绪障碍患者获得医疗服务的机会。

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