The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.
Division of Rehabilitation, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Spinal Cord. 2024 Jul;62(7):396-405. doi: 10.1038/s41393-024-00997-4. Epub 2024 May 28.
Cross-sectional survey.
Appropriate and timely lifelong access to healthcare following a spinal cord injury (SCI) is critical, yet unmet healthcare needs in this population are common. Poor experiences with healthcare providers can be a barrier to health-seeking behaviour, and we hypothesised that there would be an association between unmet healthcare needs and care experiences. This study aimed to: (1) describe healthcare provider utilisation in the past year, unmet care needs and satisfaction with healthcare services; (2) explore the association between experiences with healthcare providers and unmet healthcare needs; and (3) explore the association between healthcare provider utilisation and participant characteristics, including unmet healthcare needs.
Community.
Analysis of data for 1579 Australians aged ≥ 18, who were ≥ 1-year post-SCI and living in the community. Bayesian penalised regression was used to model six binary outcomes: unmet healthcare needs; the use of general practitioners (GPs), allied health practitioners, rehabilitation specialists; medical specialists; and hospitalisations in the past 12-months.
Unmet needs were reported by 17% of participants, with service cost the common deterrent. There was evidence of an effect for provider experiences on unmet healthcare needs, but no evidence that unmet healthcare needs was associated with the use of GPs, allied health practitioners, and rehabilitation or medical specialists.
Unmet healthcare needs were reported in the context of high healthcare use and large proportions of secondary conditions in a cohort with long-term SCI. Improved health access for people with SCI include better primary-secondary care collaboration is needed.
横断面调查。
脊髓损伤(SCI)后获得适当和及时的终生医疗保健至关重要,但该人群的未满足医疗需求很常见。与医疗服务提供者的不良体验可能成为寻求健康行为的障碍,我们假设未满足的医疗需求与护理体验之间存在关联。本研究旨在:(1)描述过去一年中医疗服务提供者的使用情况、未满足的护理需求以及对医疗服务的满意度;(2)探讨与医疗服务提供者的体验与未满足的医疗需求之间的关联;(3)探讨医疗服务提供者的利用与参与者特征(包括未满足的医疗需求)之间的关联。
社区。
对 1579 名年龄≥18 岁、≥1 年 SCI 后居住在社区的澳大利亚成年人的数据进行分析。使用贝叶斯惩罚回归来模拟六个二项结果:未满足的医疗需求;过去 12 个月内使用全科医生(GP)、辅助卫生专业人员、康复专家;医疗专家;和住院治疗。
17%的参与者报告存在未满足的需求,服务费用是常见的阻碍因素。有证据表明提供者的体验对未满足的医疗需求有影响,但没有证据表明未满足的医疗需求与 GP、辅助卫生专业人员、康复和医疗专家的使用有关。
在长期 SCI 患者中,大量存在二级疾病的情况下,报告了未满足的医疗需求。需要改善 SCI 患者的医疗服务获取途径,包括更好的初级-二级护理协作。