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前庭性眩晕与美国成年人医疗保健可及性差距。

Vestibular Vertigo and Disparities in Healthcare Access Among Adults in the United States.

机构信息

Stanford University School of Medicine, Stanford, California, USA.

Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.

出版信息

Ear Hear. 2023;44(5):1029-1035. doi: 10.1097/AUD.0000000000001344. Epub 2023 Mar 15.

Abstract

OBJECTIVE

Vertigo and dizziness have a high lifetime prevalence with significant impacts on daily life. We sought to explore differences in access to and ability to afford care among adults with vestibular vertigo by race/ethnicity, income, and insurance type.

DESIGN

This is a cross-sectional study using the 2016 National Health Interview Survey. A total of 32,047 adults who completed the 2016 National Health Interview Survey Balance Supplement were analyzed. We used a previously validated definition of vertigo defined as (1) positional vertigo, (2) rotational vertigo, or (3) recurrent dizziness with nausea and either oscillopsia or imbalance. We examined several self-reported measures of healthcare utilization and access.

RESULTS

Among adults with vestibular vertigo, African Americans had significantly increased odds of delayed care due to lack of transportation; Hispanic ethnicity was associated with decreased odds of skipping medication doses and asking a doctor for a lower-cost medication. Adults with public insurance had significantly lower odds of reporting delayed care due to worry about cost, not receiving medical care due to cost, and delayed filling of a prescription, but had greater odds of reporting delayed care due to lack of transportation. Lack of insurance and lower income were associated with increased odds of delaying and not receiving care due to cost.

CONCLUSION

These findings demonstrate significant differences in access to care among adults with vestibular vertigo in the United States based on race, income, and health insurance status.

摘要

目的

眩晕和头晕的终生患病率很高,对日常生活有重大影响。我们试图探讨不同种族/族裔、收入和保险类型的前庭性眩晕成年人在获得护理和负担能力方面的差异。

设计

这是一项使用 2016 年全国健康访谈调查的横断面研究。共分析了 32047 名完成 2016 年全国健康访谈调查平衡补充调查的成年人。我们使用了先前验证的眩晕定义,定义为 (1) 位置性眩晕,(2) 旋转性眩晕,或 (3) 伴有恶心、眼球震颤或不平衡的复发性头晕。我们检查了几种自我报告的医疗保健利用和获取措施。

结果

在患有前庭性眩晕的成年人中,由于缺乏交通工具,非裔美国人因延迟护理的可能性显著增加;西班牙裔与减少因担心费用而跳过药物剂量和向医生要求较低费用药物的可能性相关。拥有公共保险的成年人因担心费用而延迟护理、因费用而不接受医疗护理以及延迟开处方的可能性显著降低,但因缺乏交通工具而延迟护理的可能性显著增加。缺乏保险和收入较低与因费用而延迟和不接受护理的可能性增加相关。

结论

这些发现表明,在美国,基于种族、收入和健康保险状况,患有前庭性眩晕的成年人在获得护理方面存在显著差异。

相似文献

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Burden of dizziness and vertigo in the community.社区中头晕和眩晕的负担。
Arch Intern Med. 2008 Oct 27;168(19):2118-24. doi: 10.1001/archinte.168.19.2118.

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