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在多家门诊就诊的患者中,感知到的治疗负担以及与医疗服务利用相关的健康相关生活质量。

Perceived treatment burden and health-related quality of life in association with healthcare utilisation among patients attending multiple outpatient clinics.

作者信息

Bell Cathrine, Appel Charlotte Weiling, Pedersen Asger Roer, Vedsted Peter

机构信息

Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Central Denmark Region, Silkeborg/Viborg, Denmark.

Research Unit for General Practice, Aarhus, Denmark.

出版信息

Health Qual Life Outcomes. 2025 Apr 21;23(1):42. doi: 10.1186/s12955-025-02366-y.

Abstract

INTRODUCTION

Patients with multimorbidity who frequently require healthcare may experience a higher treatment burden. In this study, we investigated whether high perceived treatment burden and low perceived health-related quality of life (HRQoL) were associated with healthcare utilisation among patients who attended at least two medical outpatient hospital clinics.

METHODS

Patients who underwent medical treatment in two or more outpatient medical clinics at Silkeborg Regional Hospital in Denmark in August 2018 were included. The patients received a questionnaire containing the Multimorbidity Treatment Burden Questionnaire and the Short Form-12 questionnaire measuring HRQoL in terms of physical and mental health. Information on healthcare utilisation was collected from electronic registers one year prior to receiving the questionnaire. Logistic regression was applied to estimate the odds of 'no/low' and 'high' perceptions of treatment burden and 'low' self-rated HRQoL in relation to healthcare utilisation.

RESULTS

In total, 930 patients (59.8%) answered the questionnaire. The degree of patient-assessed treatment burden was not associated with the number of outpatient contacts, hospital admissions or admission days. A high perceived treatment burden was associated with a high number of general practice contacts, whereas a low treatment burden was associated with fewer contacts in general practice, indicating a dose‒response pattern. The same pattern of associations was observed for perceived physical and mental health.

CONCLUSION

Patients with high perceived treatment burden and low HRQoL seemed to consult their general practitioner primarily despite hospital involvement. These patients may require frequent primary care attention due to other factors than those being treated at the hospital. However, further research is warranted to explore the mechanisms underlying these associations and strategies for reducing treatment burden and enhancing HRQoL in patients with multiple medical conditions.

摘要

引言

患有多种疾病且经常需要医疗保健的患者可能会承受更高的治疗负担。在本研究中,我们调查了在至少就诊过两家医院门诊的患者中,较高的感知治疗负担和较低的感知健康相关生活质量(HRQoL)是否与医疗保健利用情况相关。

方法

纳入2018年8月在丹麦锡尔克堡地区医院的两个或更多门诊接受治疗的患者。患者收到一份问卷,其中包含多病症治疗负担问卷和用于测量身心健康方面HRQoL的简短形式-12问卷。在收到问卷前一年,从电子登记册收集医疗保健利用情况的信息。应用逻辑回归来估计与医疗保健利用相关的“无/低”和“高”治疗负担感知以及“低”自评HRQoL的几率。

结果

共有930名患者(59.8%)回答了问卷。患者评估的治疗负担程度与门诊就诊次数、住院次数或住院天数无关。高感知治疗负担与大量的全科医生就诊次数相关,而低治疗负担与较少的全科医生就诊次数相关,表明存在剂量反应模式。在感知的身心健康方面也观察到了相同的关联模式。

结论

尽管有医院参与,但感知治疗负担高且HRQoL低的患者似乎主要咨询他们的全科医生。由于除了在医院接受治疗的因素之外的其他因素,这些患者可能需要频繁的初级保健关注。然而,有必要进一步研究以探索这些关联背后的机制以及减轻患有多种疾病患者的治疗负担和提高HRQoL的策略。

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