Long Calista, Plenn Eion, Acri Samantha, Richardson Cheryl
Public Health, Penn State University College of Medicine, Milton S. Hershey Medical Center, Hershey, USA.
Cureus. 2023 Dec 27;15(12):e51156. doi: 10.7759/cureus.51156. eCollection 2023 Dec.
Introduction The living situation of individuals with intellectual disabilities (ID) has evolved throughout the years and ranges from living at home with family caregivers to group homes to independent living arrangements. Living situations can affect access to care and thus healthcare utilization seen by healthcare encounters for individuals with ID. Methods The researchers conducted a chart review of 112 patients to assess demographics, living situations, and healthcare encounters between 2019 and 2021. Living situation categories included independent, biological family, group home, home with other support, and others. Statistical analyses were conducted using R version 4.2.1 (The R Foundation for Statistical Computing, Vienna, Austria). Univariable analyses consisted of the Shapiro-Wilk test of normality, Kruskal-Wallis rank sum test, and pairwise Wilcoxon rank sum test with multiple comparisons correction using the Bonferroni method. Statistical testing for multivariable analysis included the Kruskal-Wallis rank sum test, Spearman's rank correlation, and the negative binomial model. Results Results showed a statistically significant difference in median total encounter value between independently living individuals with ID compared to all other living situations, Χ = 4.230, df = 1, p-value = 0.040. Additionally, there is a significant association between medication count and total encounter count, rho = 0.341, S = 154322, p-value < 0.001. Conclusion The study showed that individuals with ID who live independently have fewer healthcare encounters compared to all other living situations. This may be due to various factors such as increased autonomy and free choice, increased barriers to healthcare, or better overall health requiring less medical attention in independently living individuals with ID.
引言 多年来,智障人士的生活状况不断演变,范围从与家庭照顾者同住家中到集体之家,再到独立生活安排。生活状况会影响获得护理的机会,进而影响智障人士医疗保健服务的利用情况。方法 研究人员对112名患者进行了病历审查,以评估2019年至2021年期间的人口统计学、生活状况和医疗保健服务。生活状况类别包括独立生活、与亲生家庭同住、集体之家、有其他支持的家庭以及其他。使用R版本4.2.1(奥地利维也纳的R统计计算基金会)进行统计分析。单变量分析包括正态性的夏皮罗-威尔克检验、克鲁斯卡尔-沃利斯秩和检验,以及使用邦费罗尼方法进行多重比较校正的成对威尔科克森秩和检验。多变量分析的统计检验包括克鲁斯卡尔-沃利斯秩和检验、斯皮尔曼秩相关以及负二项式模型。结果 结果显示,与所有其他生活状况相比,智障独立生活个体的总就诊价值中位数存在统计学显著差异,Χ = 4.230,自由度 = 1,p值 = 0.040。此外,药物数量与总就诊次数之间存在显著关联,rho = 0.341,S = 154322,p值 < 0.001。结论 研究表明,与所有其他生活状况相比,独立生活的智障人士医疗保健服务的就诊次数较少。这可能是由于各种因素,如自主性和自由选择增加、医疗保健障碍增加,或独立生活的智障人士整体健康状况较好,需要的医疗关注较少。