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就医陪同:感官障碍的影响

Accompaniment to healthcare visits: the impact of sensory impairment.

作者信息

Reed Nicholas S, Assi Lama, Pedersen Emily, Alshabasy Yasmeen, Deemer Ashley, Deal Jennifer A, Willink Amber, Swenor Bonnielin K

机构信息

Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, 2024 E. Monument Street, Baltimore, MD, 21205, USA.

Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.

出版信息

BMC Health Serv Res. 2020 Oct 29;20(1):990. doi: 10.1186/s12913-020-05829-8.

Abstract

BACKGROUND

Millions of older adults in the United States experience hearing, vision, and dual sensory impairment (concurring hearing and vision impairment) yet little research exists on their needs in interactions with the healthcare system. This piece aims to determine the use of accompaniment in healthcare interactions by persons with sensory impairment.

METHODS

These cross-sectional analyses included data from the 2015 Medicare Current Beneficiaries Survey and survey weighting provided by Centers for Medicare and Medicaid Services. Adjusted odds of reporting accompaniment to healthcare visits and given reasons for accompaniment among United States Medicare beneficiaries with self-reported sensory impairment (hearing, vision, and dual sensory impairment) were examined.

RESULTS

After excluding observations with missing data, 10,748 Medicare beneficiaries remained representing a 46 million total weighted nationally representative sample, of which 88.9% reported no sensory impairment, 5.52% reported hearing impairment, 3.56% reported vision impairment, and 0.93% reported dual sensory impairment. Those with vision impairment and dual sensory impairment had 2.139 (95% confidence interval [CI] =1.605-2.850) and 2.703 (CI = 1.549-4.718) times the odds of reporting accompaniment to healthcare visits relative to those without sensory impairment. A secondary analysis suggests communication needs as the primary reason for accompaniment among persons with hearing loss, while those with vision impairment were more likely to indicate transportation needs.

CONCLUSIONS

Healthcare accompaniment is common for persons with sensory loss and healthcare systems should consider accommodations for and leveraging accompaniment to improve healthcare for persons with sensory impairments. In light of the current COVID-19 pandemic, as hospitals limit visitors to reduce the spread of infection, arrangements should be made to ensure that the communication and transportation needs of those with sensory impairment are not neglected.

摘要

背景

美国数百万老年人存在听力、视力和双重感官障碍(听力和视力同时受损),但关于他们在与医疗系统互动中的需求的研究却很少。本文旨在确定感官障碍者在医疗互动中使用陪同的情况。

方法

这些横断面分析纳入了2015年医疗保险当前受益人调查的数据以及医疗保险和医疗补助服务中心提供的调查权重。研究了美国医疗保险受益人中自我报告有感官障碍(听力、视力和双重感官障碍)者在就医时报告有陪同的调整后几率以及陪同的原因。

结果

在排除缺失数据的观察结果后,剩下10748名医疗保险受益人,代表全国加权总数为4600万的具有全国代表性的样本,其中88.9%报告无感官障碍,5.52%报告有听力障碍,3.56%报告有视力障碍,0.93%报告有双重感官障碍。与无感官障碍者相比,有视力障碍和双重感官障碍者就医时报告有陪同的几率分别是其2.139倍(95%置信区间[CI]=1.605-2.850)和2.703倍(CI=1.549-4.718)。一项次要分析表明,沟通需求是听力损失者陪同的主要原因,而视力障碍者更可能表示是交通需求。

结论

医疗陪同在感官丧失者中很常见,医疗系统应考虑为陪同提供便利并利用陪同来改善对感官障碍者的医疗服务。鉴于当前的新冠疫情,由于医院限制访客以减少感染传播,应做出安排以确保感官障碍者的沟通和交通需求不被忽视。

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