Kotranski L, Bolick J, Halbert J
Philadelphia Health Management Corporation, PA 19107.
J Community Health. 1987 Winter;12(4):231-45. doi: 10.1007/BF01324293.
The purpose of this paper is to examine the elderly's use of city-supported primary health care services. The provision of free or low cost health care to the elderly population is a major health policy issue, especially as the size of the elderly population increases and there is a concomitant increase in the need for health services and increases in the out-of-pocket cost of health care. The data analyzed here are based on client records for approximately 6,000 persons 65 and older who utilized the City of Philadelphia's Family Medical Care Program in 1982. Demographic and socioeconomic characteristics, diagnoses and types of services used are examined for all clients citywide and by neighborhood. Elderly clients of the city primary care system tended to be 65-74, female and black. Most clients had low incomes, with about 75-87% having incomes below $6,000. The problems for which care is sought involve long-term, ongoing care. The data show that the elderly are underrepresented in the city-supported primary care system relative to their numbers in the general population. Our findings on diagnosis and services utilization characteristics of those elderly who do use city-supported primary health care services indicate that the elderly are likely to place demands on the existing system for a substantial amount of resources. The demands for such services are likely to increase especially as the size of the elderly population increases.
本文旨在研究老年人对城市支持的初级卫生保健服务的使用情况。为老年人口提供免费或低成本的医疗保健是一个重大的卫生政策问题，尤其是随着老年人口规模的增加，对卫生服务的需求相应增加，同时医疗保健的自付费用也在增加。此处分析的数据基于1982年使用费城家庭医疗保健计划的约6000名65岁及以上人群的客户记录。对全市所有客户以及按社区划分，研究了人口统计学和社会经济特征、诊断结果以及所使用的服务类型。城市初级保健系统的老年客户往往年龄在65 - 74岁之间，女性且为黑人。大多数客户收入较低，约75% - 87%的人的收入低于6000美元。寻求医疗保健的问题涉及长期的持续护理。数据显示，相对于老年人口在总人口中的数量，他们在城市支持的初级保健系统中的占比过低。我们对那些确实使用城市支持的初级卫生保健服务的老年人的诊断和服务利用特征的研究结果表明，老年人可能会对现有系统提出大量资源需求。随着老年人口规模的增加，对此类服务的需求可能会尤其增加。
