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成人中的听力损失与医疗保健可及性

Hearing Loss and Healthcare Access among Adults.

作者信息

Mahmoudi Elham, Zazove Philip, Pleasant Terrence, Meeks Lisa, McKee Michael M

机构信息

Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.

Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan.

出版信息

Semin Hear. 2021 Feb;42(1):47-58. doi: 10.1055/s-0041-1726000. Epub 2021 Apr 15.

Abstract

Hearing loss (HL) is common among individuals aged 50 and older and is associated with increased healthcare costs. Whether HL is associated with less access to healthcare is unclear. In this study, we examined the association between HL and access to medical care and prescription drugs among individuals 50+ with and without HL. We used nationally representative 2013-2014 Medical Expenditure Panel Survey data, consisting of 1,977 adults with HL and 17,399 without. We applied an inverse propensity score weighting and regression modeling to adjust for any potential differences in health and socioeconomic conditions between the two groups. Adults with HL were more likely to be white, less educated, poorer, and with public insurance (  < 0.001). They were also likely to have hypertension, heart disease, stroke, emphysema, high cholesterol, diabetes, joint pain, and arthritis (  < 0.001). The odds of reporting unmet medical needs (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.29-2.66), delay in getting medical needs met (OR = 1.37; 95% CI = 1.00-1.87), and having unfilled prescriptions (OR = 1.81; 95% CI = 1.27-2.59) were higher among individuals with HL compared with their counterparts without HL. Individuals with HL have less access to care and prescription drugs. To ensure equitability in access, public health policies should address specific needs of people with HL.

摘要

听力损失(HL)在50岁及以上人群中很常见,并且与医疗保健成本增加相关。HL是否与获得医疗保健的机会减少有关尚不清楚。在本研究中,我们调查了50岁及以上有或无HL的个体中HL与获得医疗服务和处方药之间的关联。我们使用了具有全国代表性的2013 - 2014年医疗支出面板调查数据,其中包括1977名患有HL的成年人和17399名未患HL的成年人。我们应用逆倾向评分加权和回归模型来调整两组之间在健康和社会经济状况方面的任何潜在差异。患有HL的成年人更可能是白人、受教育程度较低、较贫困且拥有公共保险(<0.001)。他们也更可能患有高血压、心脏病、中风、肺气肿、高胆固醇、糖尿病、关节疼痛和关节炎(<0.001)。与没有HL的同龄人相比,患有HL的个体报告未满足医疗需求的几率(优势比[OR]=1.85;95%置信区间[CI]=1.29 - 2.66)、满足医疗需求的延迟(OR = 1.37;95% CI = 1.00 - 1.87)以及有未取药处方的几率(OR = 1.81;95% CI = 1.27 - 2.59)更高。患有HL的个体获得医疗服务和处方药的机会较少。为确保获得医疗服务的公平性,公共卫生政策应满足HL患者的特定需求。

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