以色列帕金森病患者对神经科及相关健康服务的利用情况：一项回顾性观察研究

Utilization of Neurology and Allied Health Services by People With Parkinson's Disease in Israel: A Retrospective Observational Study.

作者信息

Naamneh-Abuelhija Badera, Kafri Michal, Kestenbaum Meir, Shadmi Efrat, Mintz Igor, Shved Sarit, Giveon Shmuel, Kamah Sharon, Yogev-Seligmann Galit

机构信息

Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (B.N.-A., G.Y.-S.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Mi.K.); Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel (Me.K.); Neurology Department, Meir Medical Center, Kfar Saba, Israel (Me.K.); Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel (E.S.); Independent researcher, Tel Aviv, Israel (I.M.); Clalit Health Services, Sharon Shomron District, Netanya, Israel (S.G.); and Quality and Safety Department, Carmel Medical Center, Haifa, Israel (S.K.).

出版信息

J Neurol Phys Ther. 2024 Nov 25. doi: 10.1097/NPT.0000000000000502.

DOI:10.1097/NPT.0000000000000502

PMID:39601514

Abstract

BACKGROUND

Sustainable utilization of neurology and allied health professions' services is pivotal for effective management of Parkinson disease (PD) and is correlated with positive health-related outcomes.

OBJECTIVES

(1) To describe the utilization of neurology and allied health services by people with PD (PwP); (2) to explore the associations between demographic and structural variables and utilization; and (3) to test associations between utilization and unplanned hospitalizations.

METHODS

A retrospective observational cohort study of 1761 PwP in the years 2014-2019 was conducted. Utilization of neurology and allied health services was mapped. Regression models were examined to test associations between demographic and structural variables, utilization of neurology and physical therapy (PT), and unplanned hospitalizations.

RESULTS

Approximately 50% of the study population utilized neurology services. Utilization rate of allied health services ranged between 0% and 19%. The likelihood of utilizing neurology services increased for people with extended health insurance and people with more years since diagnosis and decreased for women and for people living at a great distance from a neurology service. The likelihood of utilizing PT increased for Jews and people with extended health insurance and decreased for people with more years since diagnosis and for people living at a great distance from a PT service. Among patients with fewer years since diagnosis (<5 years), those who utilized PT had a higher likelihood of unplanned hospitalization.

CONCLUSIONS

Neurology and allied health services are underutilized by PwP, particularly by minorities and women. Policymakers should take proactive steps to increase utilization.

VIDEO ABSTRACT AVAILABLE

for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A496 ).

摘要

背景

神经科及相关健康专业服务的可持续利用对于帕金森病（PD）的有效管理至关重要，且与积极的健康相关结果相关。

目的

（1）描述帕金森病患者（PwP）对神经科及相关健康服务的利用情况；（2）探讨人口统计学和结构变量与服务利用之间的关联；（3）检验服务利用与非计划住院之间的关联。

方法

对2014 - 2019年间1761名帕金森病患者进行回顾性观察队列研究。绘制神经科及相关健康服务的利用情况图。采用回归模型检验人口统计学和结构变量、神经科及物理治疗（PT）服务利用情况与非计划住院之间的关联。

结果

约50%的研究人群利用了神经科服务。相关健康服务的利用率在0%至19%之间。拥有长期医疗保险的患者、确诊后年限较长的患者使用神经科服务的可能性增加，而女性患者以及居住距离神经科服务机构较远的患者使用神经科服务的可能性降低。犹太人和拥有长期医疗保险的患者使用PT服务的可能性增加，而确诊后年限较长的患者以及居住距离PT服务机构较远的患者使用PT服务的可能性降低。在确诊年限较短（<5年）的患者中，使用PT服务的患者非计划住院的可能性更高。