Epilepsy is associated with unmet health care needs compared to the general population despite higher health resource utilization-A Canadian population-based study
Epilepsy is associated with unmet health care needs compared to the general population despite higher health resource utilization-A Canadian population-based study
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DOI：
10.1111/j.1528-1167.2011.03353.x
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发表时间：
2012-02-01
期刊：
影响因子：
5.6
通讯作者：
Jette, Nathalie
中科院分区：
文献类型：
--
作者：
Reid, Aylin Y.;Metcalfe, Amy;Jette, Nathalie
目的：（1）确定癫痫患者的卫生资源利用（HRU）和未满足的卫生保健需求与普通人群或其他慢性疾病患者相比是否存在差异（哮喘、糖尿病、偏头痛）;（2）评估癫痫状态、社会人口学变量和HRU之间的关系。使用2001 - 2005年加拿大社区健康调查，一个全国代表性的人口为基础的调查，对HRU的数据进行了评估。相关性的加权估计值以调整后的比值比（95%置信区间）计算，Logistic回归用于探讨癫痫患者社会人口学变量与HRU之间的相关性。所有关于疾病状态、HRU和未满足的医疗保健需求的数据均为自我报告。关键发现：癫痫患者的住院率最高，与医生的平均协商次数最多。尽管与一般人群相比，与心理学家和社会工作者进行咨询的比例更高，但癫痫患者更有可能表示他们有未满足的精神卫生保健需求。与普通人群相比，癫痫患者也不太可能使用牙科服务。癫痫是一个显着的预测HRU在logistic回归models.Significance：考虑到精神病合并症的患病率在癫痫患者，这是令人担忧的是，这组感知未满足的心理健康护理需求。同样令人烦恼的是，考虑到癫痫患者更有可能口腔健康状况不佳，这些患者对牙科保健资源的利用率下降。虽然癫痫患者比一般人群使用更多的医疗保健服务，但这种增长似乎不足以满足他们的医疗保健需求。
Purpose: (1) To determine whether health resource utilization (HRU) and unmet health care needs differ for individuals with epilepsy compared to the general population or to those with another chronic condition (asthma, diabetes, migraine); and (2) to assess the association among epilepsy status, sociodemographic variables and HRU.Methods: Data on HRU were assessed using the 20012005 Canadian Community Health Surveys, a nationally representative population-based survey. Weighted estimates of association were produced as adjusted odds ratio with 95% confidence intervals, and logistic regression was used to explore the association between sociodemographic variables and HRU in those with epilepsy. All data on disease status, HRU, and unmet health care needs were self-reported.Key Findings: Individuals with epilepsy had the highest rate of hospitalizations and the highest mean number of consultations with physicians. Despite higher rates of consultation with psychologists and social workers compared to the general population, those with epilepsy were significantly more likely to say they had unmet mental health care needs. People with epilepsy were also less likely to use dental services compared to the general population. Epilepsy was a significant predictor of HRU in logistic regression models.Significance: Given the prevalence of psychiatric comorbidities in those with epilepsy, it is concerning that this group perceives unmet mental health care needs. It is also troublesome that there was decreased utilization of dental health care resources in those with epilepsy considering that these patients are more likely to have poor oral health. Although individuals with epilepsy use more health care services than the general population, this increase appears to be insufficient to address their health care needs.