Wellkamp Randi, de Cruppé Werner, Schwalen Susanne, Geraedts Max
Institut für Gesundheitssystemforschung, Universität Witten/Herdecke, Witten, Deutschland.
Institut für Versorgungsforschung und Klinische Epidemiologie, Marburg, Philipps-Universität Marburg, Deutschland.
Gesundheitswesen. 2022 May;84(5):457-465. doi: 10.1055/a-1330-8081. Epub 2021 Apr 22.
People with intellectual disabilities have a lower life expectancy and more frequent comorbidities than the general population and have unmet health needs. Insufficient medical care is suspected to be one reason, for which little data is available in Germany. The study therefore focuses on the question of how people with intellectual disabilities make use of medical care, including screening and preventive measures.
In a cross-sectional study in 3 workshops for people with intellectual disabilities, the use of health care was surveyed by means of questionnaires from their relatives. The evaluation was carried out descriptively and by means of inferential statistics comparing participants with the general population as well as within the group of participants for socio-demographic differences.
Almost all 181 participants (participation rate 19.3%) had a family doctor. In comparison to the general population, the participants made more frequent use of the services of general practitioners and the care provided by numerous other specialist areas. They made less frequent use of screening for colon, breast, cervix and prostate and more frequent use for skin cancer and general check-up. Dental check-ups and preventive measures showed no difference. Participants living in institutional settings made more use of the regular services than those living with relatives or alone. Participants with a migration background were less aware of care services.
The results do not show any indications of a general undersupply of health care. Participation in cancer screening with more complex examinations should be encouraged, especially for people with mental disabilities living alone or with relatives. Those with a migration background and their families should be specifically informed.
与普通人群相比,智障人士预期寿命较短,合并症更为常见,且有未得到满足的健康需求。医疗护理不足被怀疑是其中一个原因,而在德国,这方面的数据很少。因此,本研究聚焦于智障人士如何利用医疗护理,包括筛查和预防措施这一问题。
在针对智障人士的3个工作坊开展的一项横断面研究中,通过向其亲属发放问卷来调查医疗护理的使用情况。采用描述性方法以及推断性统计进行评估,将参与者与普通人群进行比较,并在参与者群体内部比较社会人口学差异。
几乎所有181名参与者(参与率19.3%)都有家庭医生。与普通人群相比,参与者更频繁地使用全科医生服务以及众多其他专科领域提供的护理。他们较少进行结肠癌、乳腺癌、宫颈癌和前列腺癌筛查,而皮肤癌筛查和全身检查更为频繁。牙科检查和预防措施没有差异。居住在机构环境中的参与者比与亲属同住或独居的参与者更多地使用常规服务。有移民背景的参与者对护理服务的了解较少。
结果并未显示出医疗护理普遍供应不足的迹象。应鼓励参与更为复杂检查的癌症筛查,尤其是对于独居或与亲属同住的智障人士。应特别告知有移民背景者及其家人。