老年人的医疗保健差异：探索健康和认知水平的社会决定因素。
Healthcare Disparities Among Older Adults: Exploring Social Determinants of Health and Cognition Levels.
作者信息
Rahemi Zahra, Bacsu Juanita-Dawne R, Shalhout Sophia Z, Sadafipoor Maryam S, Smith Matthew Lee, Adams Swann Arp
机构信息
School of Nursing, Clemson University.
School of Nursing, Thompson Rivers University, 805 TRU Way, Kamloops, BC V2C 0C8 Canada.
出版信息
medRxiv. 2024 Jul 1:2024.06.29.24309705. doi: 10.1101/2024.06.29.24309705.
BACKGROUND
The purpose was to investigate the impact of sociodemographic factors on healthcare utilization among adults with different cognition levels (normal and impairment/dementia).
METHODS
We used cross-sectional data from the Health and Retirement Study (N=17,698) to assess healthcare utilization: hospital stay, nursing home stay, hospice care, and doctor visits.
RESULTS
A cohort comparison between normal and dementia/impaired cognition groups revealed significant differences. The dementia/impaired group had lower education levels, higher single/widowed status, and more racial and ethnic minorities. They experienced longer hospital and nursing home stays, varied doctor visit frequencies, and had higher mean age, greater loneliness scores, and lower family social support scores. Differences in hospitalization, nursing home, hospice care, and doctor visits were influenced by factors such as race, age, marital status, education, and rurality.
CONCLUSION
There were disparities in healthcare utilization based on participants' characteristics and cognition levels, especially in terms of race/ethnicity, education, and rural location.
背景
目的是调查社会人口学因素对不同认知水平（正常和认知障碍/痴呆）成年人医疗保健利用情况的影响。
方法
我们使用来自健康与退休研究的横断面数据（N = 17,698）来评估医疗保健利用情况：住院、养老院入住、临终关怀和看医生。
结果
正常认知组与痴呆/认知障碍组之间的队列比较显示出显著差异。痴呆/认知障碍组的教育水平较低，单身/丧偶状态较多，种族和族裔少数群体较多。他们的住院和养老院入住时间更长，看医生的频率各不相同，平均年龄更高，孤独感得分更高，家庭社会支持得分更低。住院、养老院、临终关怀和看医生方面的差异受到种族、年龄、婚姻状况、教育程度和农村地区等因素的影响。
结论
基于参与者的特征和认知水平，在医疗保健利用方面存在差异，特别是在种族/族裔、教育程度和农村地区方面。
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