Zimmer-Gembeck M J, Alexander T, Nystrom R J
Multnomah County Health Department, Portland, OR 97204, USA.
J Adolesc Health. 1997 Dec;21(6):388-99. doi: 10.1016/S1054-139X(97)00167-5.
The goals of this study were to describe student access to health care services, identify populations of students who remained in need of health care services, and highlight particular unmet needs for health care identified by these adolescents.
Students in Grades 9-12 attending 50 schools in Oregon completed the Youth Risk Behavior Surveillance Survey (YRBS). Questions requesting adolescents to report their need for specific types of health care, and access to general and specific types of care were added to the core YRBS. Multivariate logistic regression analysis was used to determine independent relationships between student or community characteristics and health care access or unmet needs for care.
Almost 14,000 adolescents completed surveys, of whom 75% reported visiting one or more health care provider within the last 12 months. Nineteen percent of adolescents reported that they had not received 1 or more of 10 specific types of care when needed in the last year. Females, some racial/ethnic minorities, rural, and sexually active adolescents were more likely to report unmet needs for health care. Most frequently, adolescents reported they needed but did not receive care for an illness (7%) or for personal or emotional problems (6%). In addition, about 400 (3%) students reported they needed birth control that they did not receive.
A majority of high school-age adolescents had visited health care providers within the year prior to study. However, the number of adolescents who reported unmet specific health care needs within the same time period remained substantial.
本研究的目标是描述学生获得医疗保健服务的情况，确定仍需要医疗保健服务的学生群体，并突出这些青少年所确定的未满足的特定医疗保健需求。
俄勒冈州50所学校的9至12年级学生完成了青少年风险行为监测调查（YRBS）。在YRBS核心内容中增加了要求青少年报告对特定类型医疗保健的需求以及获得一般和特定类型护理情况的问题。使用多变量逻辑回归分析来确定学生或社区特征与医疗保健获得情况或未满足的护理需求之间的独立关系。
近14000名青少年完成了调查，其中75%报告在过去12个月内拜访过一名或多名医疗保健提供者。19%的青少年报告说，他们在去年需要时未获得10种特定类型护理中的1种或更多种。女性、一些种族/族裔少数群体、农村青少年和性活跃青少年更有可能报告未满足的医疗保健需求。青少年最常报告他们需要但未获得疾病护理（7%）或个人或情感问题护理（6%）。此外，约400名（3%）学生报告他们需要但未获得节育服务。
在研究前一年，大多数高中年龄的青少年拜访过医疗保健提供者。然而，在同一时期报告未满足特定医疗保健需求的青少年人数仍然很多。
