Baumgarten M, Battista R N, Infante-Rivard C, Hanley J A, Becker R, Bilker W B, Gauthier S
Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia 19104-6021, USA.
J Clin Epidemiol. 1997 Nov;50(11):1265-72. doi: 10.1016/s0895-4356(97)00168-6.
It is well known that there is an excess of physical and psychological health problems among family caregivers of elderly persons with Alzheimer's disease and other dementias. The objective of this study was to determine whether the higher level of morbidity translates into a higher level of medical care utilization. Data from a previously completed longitudinal study of caregivers for elderly persons with dementia were merged with data on physician visits obtained from the computerized records of the Quebec Health Insurance Board. Utilization of physician care (adjusted for age, sex, number of chronic diseases, and depression) was no higher for family caregivers of elderly patients with Alzheimer's disease and other dementias than for comparable family members of older persons without dementia. The annual cost of physician care was almost identical among caregivers and noncaregivers. However, the pattern of utilization for the two groups was somewhat different: there was a significantly higher frequency of physician utilization among caregivers for services billed by psychiatrists and internal medicine specialists. In multivariate analysis, physician utilization was significantly associated with having more than one chronic condition and with increased age. Future studies should focus on determining whether caregivers neglect their own health care needs as a result of the exigencies of the caregiving role.
众所周知，患有阿尔茨海默病和其他痴呆症的老年人的家庭护理人员存在过多的身心健康问题。本研究的目的是确定较高的发病率是否转化为较高的医疗服务利用率。一项先前完成的针对老年痴呆症患者护理人员的纵向研究数据与从魁北克医疗保险委员会的计算机记录中获取的医生就诊数据合并。患有阿尔茨海默病和其他痴呆症的老年患者的家庭护理人员对医生护理的利用率（根据年龄、性别、慢性病数量和抑郁情况进行调整）并不高于没有痴呆症的老年人的可比家庭成员。护理人员和非护理人员的年度医生护理费用几乎相同。然而，两组的使用模式略有不同：护理人员中精神科医生和内科专家计费服务的医生利用率明显更高。在多变量分析中，医生利用率与患有多种慢性病和年龄增长显著相关。未来的研究应侧重于确定护理人员是否由于护理角色的紧迫性而忽视了自己的医疗保健需求。
