Mental Health and Wellbeing Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
J Appl Res Intellect Disabil. 2021 Mar;34(2):634-647. doi: 10.1111/jar.12833. Epub 2020 Nov 30.
Quality of primary healthcare impacts on health outcomes. This study aimed to quantify trends in good practice and the healthcare inequalities gap.
Indicators of best-practice management of long-term conditions and health promotion were extracted from primary healthcare records on 721 adults with intellectual disabilities in 2007-2010, and 3638 in 2014. They were compared over time, and with the general population in 2014, using Fisher's Exact test and ordinal regression.
Management improved for adults with intellectual disabilities over time (OR = 5.32; CI = 2.69-10.55), but not for the general population (OR = 0.74; CI = 0.34-1.64). However, it remained poorer, but to a lesser extent, compared with the general population (OR = 0.38; CI = 0.20-0.73 in 2014, and OR = 0.05; CI = 0.02-0.12 in 2007-2010). In 2014, health care was comparable to the general population on 49/78 (62.8%) indicators.
The extent of the healthcare inequality gap reduced over this period, but remaining inequalities highlight that further action is still necessary.
初级医疗保健的质量对健康结果有影响。本研究旨在量化良好实践的趋势和医疗保健不平等差距。
从 2007-2010 年和 2014 年的 721 名智力残疾成年人以及 3638 名成年人的初级保健记录中提取了长期疾病管理和健康促进的最佳实践指标。使用 Fisher 精确检验和有序回归比较了随时间的变化，并与 2014 年的一般人群进行了比较。
随着时间的推移，智力残疾成年人的管理水平有所提高（OR=5.32；CI=2.69-10.55），但一般人群的管理水平并没有提高（OR=0.74；CI=0.34-1.64）。然而，与一般人群相比，它仍然较差，但程度较轻（2014 年 OR=0.38；CI=0.20-0.73，2007-2010 年 OR=0.05；CI=0.02-0.12）。2014 年，在 78 项指标中有 49 项（62.8%）与一般人群相当。
在此期间，医疗保健不平等差距的程度有所缩小，但仍存在不平等现象，这表明仍需采取进一步行动。
