Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
Instituto de Efectividad Clinica y Sanitaria, Dr. Emilio Ravignani 2024, C1414CPV, Buenos Aires, Argentina.
Qual Life Res. 2021 Apr;30(4):1005-1015. doi: 10.1007/s11136-020-02704-1. Epub 2020 Nov 28.
Little is known on the association of health care access and health-related quality of life (HRQoL) in people with diabetes in the Southern Cone of Latin America (SCLA).
We analyzed data of 1025 participants of CESCAS I. To determine HRQoL, we used the SF-12 physical (PCS-12) and mental component summary (MCS-12). We compared four groups regarding HRQoL: (a) insured people without self-reported barriers to health care, (b) uninsured people without self-reported barriers to health care, (c) insured people with self-reported barriers to health care, and (d) uninsured people with self-reported barriers to health care. We conducted linear regressions with PCS-12 and MCS-12 as outcome. We adjusted for sociodemographic and disease-related factors and having access to a primary physician.
In the first group, there were 407, in the second 471, in the third 44, and in the fourth group 103 participants. Compared to the first group, PCS-12 was 1.9 points lower (95% Confidence Interval, CI: - 3.5, - 0.3) in the second, 4.5 points (95% CI: - 8.1, - 1) lower in the third, and 6.1 points lower (95% CI: - 8.7, - 3.6) in the fourth group. Compared to the first group, MCS-12 was 0.6 points lower (95% CI: - 2.7, 1.4) in the second, 4.8 points lower (95% CI: - 9.3, - 0.3) in the third, and 5.8 points lower (95% CI: - 9.1, - 2.5) in the fourth group.
In the SCLA, impeded access to care is common in people with diabetes. Self-reported barriers to care may be more important than insurance status in determining HRQoL.
在南锥体拉丁美洲（SCLA）的糖尿病患者中，关于医疗保健的可及性与健康相关生活质量（HRQoL）之间的关联知之甚少。
我们分析了 CESCAS I 中 1025 名参与者的数据。为了确定 HRQoL，我们使用了 SF-12 身体（PCS-12）和心理成分综合评分（MCS-12）。我们根据 HRQoL 将四组进行了比较：（a）有保险且无自报医疗保健障碍的人，（b）无保险且无自报医疗保健障碍的人，（c）有保险但自报有医疗保健障碍的人，和（d）无保险且自报有医疗保健障碍的人。我们进行了线性回归，将 PCS-12 和 MCS-12 作为结果。我们调整了社会人口统计学和疾病相关因素以及获得初级保健医生的情况。
第一组有 407 名参与者，第二组有 471 名，第三组有 44 名，第四组有 103 名。与第一组相比，第二组的 PCS-12 低 1.9 分（95%置信区间，CI：-3.5，-0.3），第三组低 4.5 分（95% CI：-8.1，-1），第四组低 6.1 分（95% CI：-8.7，-3.6）。与第一组相比，第二组的 MCS-12 低 0.6 分（95% CI：-2.7，1.4），第三组低 4.8 分（95% CI：-9.3，-0.3），第四组低 5.8 分（95% CI：-9.1，-2.5）。
在 SCLA，糖尿病患者获得医疗保健的障碍很常见。自报的医疗保健障碍可能比保险状况更能决定 HRQoL。
