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卫生保健利用、过渡准备情况和生活质量:潜在类别分析。

Health Care Utilization, Transition Readiness, and Quality of Life: A Latent Class Analysis.

机构信息

Department of Psychology, Oklahoma State University.

出版信息

J Pediatr Psychol. 2021 Feb 19;46(2):197-207. doi: 10.1093/jpepsy/jsaa099.

Abstract

OBJECTIVE

To identify possible subgroups of health care utilization (HCU) patterns among adolescents and young adults (AYAs) with a chronic medical condition (CMC), and examine how these patterns relate to transition readiness and health-related quality of life (HRQoL).

METHODS

Undergraduates (N = 359; Mage=19.51 years, SD = 1.31) with a self-reported CMC (e.g., asthma, allergies, irritable bowel syndrome) completed measures of demographics, HCU (e.g., presence of specialty or adult providers, recent medical visits), transition readiness, and mental HRQoL (MHC) and physical HRQoL (PHC). Latent class analysis identified four distinct patterns of HCU. The BCH procedure evaluated how these patterns related to transition readiness and HRQoL outcomes.

RESULTS

Based on seven indicators of HCU, a four-class model was found to have optimal fit. Classes were termed High Utilization (n = 95), Adult Primary Care Physician (PCP)-Moderate Utilization (n = 107), Family PCP-Moderate Utilization (n = 81), and Low Utilization (n = 76). Age, family income, and illness controllability predicted class membership. Class membership predicted transition readiness and PHC, but not MHC. The High Utilization group reported the highest transition readiness and the lowest HRQoL, while the Low Utilization group reported the lowest transition readiness and highest HRQoL.

CONCLUSIONS

The present study characterizes the varying degrees to which AYAs with CMCs utilize health care. Our findings suggest poorer PHC may result in higher HCU, and that greater skills and health care engagement may not be sufficient for optimizing HRQoL. Future research should examine the High Utilization subgroup and their risk for poorer HRQoL.

摘要

目的

确定患有慢性疾病(CMC)的青少年和年轻人(AYA)的医疗保健利用(HCU)模式的可能亚组,并研究这些模式与过渡准备和健康相关的生活质量(HRQoL)之间的关系。

方法

359 名大学生(Mage=19.51 岁,SD=1.31)报告了自己患有 CMC(例如哮喘、过敏、肠易激综合征),完成了人口统计学、HCU(例如是否有专科或成人提供者、最近的医疗就诊)、过渡准备以及心理健康相关的生活质量(MHC)和身体相关的生活质量(PHC)的测量。潜在类别分析确定了 HCU 的四种不同模式。BCH 程序评估了这些模式与过渡准备和 HRQoL 结果之间的关系。

结果

基于 HCU 的七个指标,发现四类别模型具有最佳拟合度。类别分别为高利用(n=95)、成人初级保健医生(PCP)中度利用(n=107)、家庭 PCP 中度利用(n=81)和低利用(n=76)。年龄、家庭收入和疾病可控性预测了类别归属。类别归属预测了过渡准备和 PHC,但不预测 MHC。高利用组报告了最高的过渡准备和最低的 HRQoL,而低利用组报告了最低的过渡准备和最高的 HRQoL。

结论

本研究描述了患有 CMC 的 AYA 利用医疗保健的不同程度。我们的研究结果表明,较差的 PHC 可能导致更高的 HCU,而更多的技能和医疗保健参与可能不足以优化 HRQoL。未来的研究应该检查高利用亚组及其较差的 HRQoL 风险。

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