Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Prev Med. 2022 Nov;164:107308. doi: 10.1016/j.ypmed.2022.107308. Epub 2022 Oct 13.
Previous studies showed that older adults with fair or poor self-rated health (SRH) were more likely to experience delayed care during the COVID-19 pandemic. We aim to understand delayed care patterns by SRH during the COVID-19 pandemic among US older adults.
Using a nationally representative sample of older adults (≥ 70 years old) from the National Health and Aging Trends Study (NHATS), we assessed the patterns of delayed care by good, fair, or poor SRH.
Nearly one in five of the survey-weighted population of 9,465,117 older adults who experienced delayed care during the pandemic reported fair or poor SRH. The overall distributions of the numbers of types of delayed care (p = 0.16) and the numbers of reasons for delayed care (p = 0.12) did not differ significantly by SRH status. Older adults with good, fair, or poor SRH shared the four most common types of delayed care and three most common reasons for delayed care but differed in ranking. Older adults with poor SRH mostly delayed seeing a specialist (good vs. fair vs. poor SRH: 40.1%, 46.7%, 73%, p = 0.01).
The results suggest that utilizing SRH as a simple indicator may help researchers and clinicians understand similarities and differences in care needs for older adults during the pandemic. Targeted interventions that address differences in healthcare needs among older adults by SRH during the evolving pandemic may mitigate the negative impacts of delayed care.
既往研究显示,自我报告健康状况一般或较差的老年人在 COVID-19 大流行期间更有可能延迟护理。本研究旨在了解美国老年人群体在 COVID-19 大流行期间自我报告健康状况不同的老年人的延迟护理模式。
我们使用来自全国健康老龄化趋势研究(NHATS)的老年人群体(≥70 岁)的全国代表性样本,评估自我报告健康状况良好、一般或较差的老年人的延迟护理模式。
在经历大流行期间延迟护理的 9465117 名经调查加权的老年人中,近五分之一报告自我报告健康状况一般或较差。按自我报告健康状况划分,延迟护理的类型数量(p=0.16)和延迟护理原因数量(p=0.12)的总体分布无显著差异。自我报告健康状况良好、一般或较差的老年人有共同的四种最常见的延迟护理类型和三种最常见的延迟护理原因,但在排名上存在差异。自我报告健康状况较差的老年人大多延迟了专科就诊(良好、一般和较差自我报告健康状况:40.1%、46.7%、73%,p=0.01)。
研究结果表明,利用自我报告健康状况作为一个简单的指标可能有助于研究人员和临床医生了解大流行期间老年人群体的护理需求的异同。在不断演变的大流行期间,针对自我报告健康状况不同的老年人的医疗保健需求差异制定有针对性的干预措施,可能有助于减轻延迟护理的负面影响。