Muehlan Holger, Alvarelhao Joaquim, Arnaud Catherine, Cytera Chirine, Fauconnier Jerome, Himmelmann Kate, Marcelli Marco, Markwart Henriette, Rapp Marion, Schmidt Silke, Thyen Ute
Department Health and Prevention, University of Greifswald, Greifswald, Germany.
School of Health Sciences, University of Aveiro, Aveiro, Portugal.
Front Med (Lausanne). 2024 Jan 30;11:1306504. doi: 10.3389/fmed.2024.1306504. eCollection 2024.
Young people with chronic health conditions and disabilities rely on the healthcare system to maintain their best possible health. The appropriate delivery and utilization of healthcare services are key to improve their autonomy, self-efficacy and employment outcomes. The research question of our study is directed toward investigating if poor availability and accessibility of healthcare services in general, as identified by unmet needs in healthcare, are associated with dissatisfaction with healthcare.
Within a European multicenter observational study, 357 young adults with cerebral palsy aged 19-28 were included. We assessed special healthcare needs, utilization of healthcare services, and satisfaction with healthcare applying the short-form of the YHC-SUN-SF, environmental and social variables (EAEQ) as well as indicators for severity of condition and functionality (e.g., GMFCS) of these participants based on a self-, assisted self- or proxy-reports. We used correlation analyses to explore associations between satisfaction with healthcare and respective indicators related to availability and accessibility of healthcare services as well as severity of the condition. In addition, we included reference values for satisfaction with heath care from young adults with various chronic conditions assessed within population-based surveys from some of the European countries included in the study.
We identified several unmet healthcare needs, especially for widely used and established services (e.g., physical therapy). Satisfaction with healthcare (YHC-SUN-SF general and subscale scores) was moderate to high and almost consistently better for the sample of young adults with cerebral palsy as compared to reference values for young adults with various chronic conditions assessed within general population surveys). Correlation coefficients between satisfaction with healthcare and utilization of services and (unmet) healthcare needs were low, also with different indicators for severity of the condition or functionality.
Young adults with cerebral palsy reports of unmet healthcare needs varied largely but showed substantial deficits in some aspects. This seems to have no impact on the satisfaction with healthcare those patients currently receive. We conclude that these are two different constructs and somewhat independent indicators to evaluate the quality of healthcare. Clinicians and other practitioners should consider this distinction when monitoring patient needs in their daily practice.
患有慢性健康问题和残疾的年轻人依靠医疗保健系统来维持尽可能好的健康状况。医疗保健服务的适当提供和利用是提高他们的自主性、自我效能感和就业成果的关键。我们研究的问题是调查医疗保健方面未满足的需求所表明的总体医疗保健服务的可及性和可得性差是否与对医疗保健的不满相关。
在一项欧洲多中心观察性研究中,纳入了357名年龄在19至28岁之间的脑瘫青年成年人。我们基于自我报告、协助自我报告或代理报告,使用YHC-SUN-SF简表、环境和社会变量(EAEQ)以及这些参与者的病情严重程度和功能指标(如GMFCS)来评估特殊医疗保健需求、医疗保健服务的利用情况以及对医疗保健的满意度。我们使用相关分析来探讨对医疗保健的满意度与医疗保健服务的可得性和可及性相关指标以及病情严重程度之间的关联。此外,我们纳入了在该研究纳入的一些欧洲国家基于人群的调查中评估的患有各种慢性病的青年成年人对医疗保健满意度的参考值。
我们确定了一些未满足的医疗保健需求,特别是对于广泛使用且已确立的服务(如物理治疗)。与在一般人群调查中评估的患有各种慢性病的青年成年人的参考值相比,脑瘫青年成年人样本对医疗保健的满意度(YHC-SUN-SF总体和子量表得分)为中度至高度,且几乎一直更好。对医疗保健的满意度与服务利用情况和(未满足的)医疗保健需求之间的相关系数较低,与病情严重程度或功能的不同指标之间的相关系数也较低。
脑瘫青年成年人报告的未满足的医疗保健需求差异很大,但在某些方面存在明显不足。这似乎对这些患者目前接受的医疗保健满意度没有影响。我们得出结论,这是两个不同的概念,并且在某种程度上是评估医疗保健质量的独立指标。临床医生和其他从业者在日常实践中监测患者需求时应考虑到这种区别。