McCormick W C, Hopkins S G, Wood R W, Wood C D, Deyo R A, Inui T S
Department of Medicine, University of Washington, Seattle 98195.
AIDS Care. 1993;5(3):369-78. doi: 10.1080/09540129308258619.
We surveyed 77 persons with AIDS, their physicians and their social workers during the autumn of 1987 to ascertain health status and to quantify use of health services in Seattle, Washington. Participants included the majority (59%) of persons living with AIDS in the area. Information was gathered regarding demography, health status, functional status, medical history and the use of health services. The validity of self-assessed general health was corroborated by the physician-rated Karnovsky score (kappa = 0.59), by social worker assessment (kappa = 0.41), and by correlation with functional status (r = 0.6-0.8). We found more frequent use of health services (categorized into skilled services, chore services and physician services) among AIDS patients who were dependent in basic and instrumental daily activities, had low income, had poor self-assessed general health, lived alone or lacked an available support person at home. These associations persisted in multivariate analyses, and accounted for 6-23% of the variability in service use. We conclude that health and functional status of persons with AIDS can be estimated via mailed questionnaires and accounts for a modest amount of the variability in use of health services.
1987年秋，我们对华盛顿州西雅图市的77名艾滋病患者、他们的医生以及他们的社会工作者进行了调查，以确定其健康状况并量化其对医疗服务的使用情况。参与者包括该地区大多数（59%）的艾滋病患者。我们收集了有关人口统计学、健康状况、功能状态、病史以及医疗服务使用情况的信息。自我评估的总体健康状况的有效性通过医生评定的卡氏评分（kappa = 0.59）、社会工作者评估（kappa = 0.41）以及与功能状态的相关性（r = 0.6 - 0.8）得到了证实。我们发现，在基本和工具性日常活动方面存在依赖、收入低、自我评估的总体健康状况差、独居或家中缺乏可提供支持的人的艾滋病患者中，对医疗服务（分为专业服务、家务服务和医生服务）的使用更为频繁。这些关联在多变量分析中依然存在，并解释了服务使用差异的6% - 23%。我们得出结论，艾滋病患者的健康和功能状态可以通过邮寄问卷进行评估，并且在医疗服务使用差异中占一定比例。
