Health care utilization and receipt of cholesterol testing by veterans with and those without mental illness
Health care utilization and receipt of cholesterol testing by veterans with and those without mental illness
复制标题
DOI：
10.1016/j.genhosppsych.2005.10.002
复制
发表时间：
2006-03-01
影响因子：
7
通讯作者：
Gaziano, JM
中科院分区：
文献类型：
--
作者：
Kaplowitz, RA;Scranton, RE;Gaziano, JM
目的：探讨精神疾病、医疗服务利用与胆固醇检测率之间的关系。方法：利用退伍军人事务部(VA)的管理数据，对1998年1月至2001年6月间使用退伍军人新英格兰医疗保健系统门诊服务的64,490名美国退伍军人进行了回顾性队列研究。共有10,100名退伍军人(15.7%)接受了药物治疗的精神疾病。结果：在不经常使用退伍军人门诊服务的退伍军人中，精神病患者在研究期间接受胆固醇测试的可能性低于非精神病受试者(第一个四分位数调整后的OR=0.45，95%CI=0.37-0.54；第二个四分位数调整后的OR=0.50，95%CI=0.45-0.57)。更频繁使用VA服务的精神病患者接受胆固醇测试的可能性与非精神病患者(调整后OR=1.01，95%CI=0.91~1.13)或非精神病患者(调整后OR=2.73，95%CI=2.46~3.03)一样高。结论：较少使用VA门诊服务的患者，精神疾病与胆固醇测试的可能性较低。观察到的差异在较高的服务利用率水平上有所减弱。(C)2006 Elsevier Inc.保留所有权利。
Objective: We examined the relationship between mental illness, health care utilization and rates of cholesterol testing.Methods: We conducted a retrospective cohort study using Veterans Affairs (VA) administrative data on 64,490 United States veterans who used VA New England Health Care System outpatient services between January 1998 and June 2001. A total of 10,100 veterans (15.7%) had a mental illness treated with medication. We examined the interaction between mental illness and outpatient service utilization with respect to the likelihood of receiving a cholesterol test, adjusting for major demographic and clinical covariates.Results: Among veterans using VA outpatient services infrequently, those with mental illness were less likely than non-mentally in control subjects to receive a cholesterol test during the study period (first quartile adjusted OR=0.45, 95% CI=0.37-0.54; second quartile adjusted OR=0.50, 95% CI=0.45-0.57). Mentally ill subjects with more frequent utilization of VA services were as likely as (third quartile adjusted OR=1.01, 95% CI=0.91-1.13) or more likely than (fourth quartile adjusted OR=2.73, 95% CI=2.46-3.03) non-mentally ill subjects to receive cholesterol testing.Conclusions: Mental illness was associated with a lower likelihood of cholesterol testing in subjects who used fewer VA outpatient services. The observed disparity attenuated at higher levels of service utilization. (c) 2006 Elsevier Inc. All rights reserved.