Prior Depression and Health Insurance in Non-receipt of Needed Medical Services.
Prior Depression and Health Insurance in Non-receipt of Needed Medical Services.
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既往抑郁症和未接受所需医疗服务的健康保险。
DOI：
10.1016/j.amepre.2015.01.021
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发表时间：
2015
影响因子：
5.5
通讯作者：
Lovasi,GinaS
中科院分区：
文献类型：
--
作者：
Wutchiett,DavidM;Lovasi,GinaS
在未参保和社会人口亚群中，无法获得所需医疗服务的比率较高。临床抑郁症与并存的内科疾病和治疗依从性降低有关。这项研究的目的是检验既往抑郁症是否预测错过了所需的医疗保健，独立于医疗保险状况和社会经济和人口特征。方法数据来自具有代表性的横断面样本，通过2009(n=9,900)和2010(n=8,622)年度社区健康调查进行调查。采用Logistic回归方法，按医疗保险状况进行分层，并对社会经济特征进行调整，以评估过去一年中终生抑郁与错过所需医疗服务的关系。结果在参保(OR=1.9，95%CI=1.7，2.2)和未参保(OR=1.8，95%CI=1.3，2.4)成人中，既往抑郁与遗漏就医有关。未参保状况(OR=3.6，95%CI=3.1，4.0)与未参保状况(OR=3.6，95%CI=3.1，4.0)、就业、收入和人口统计学因素相关。结论抑郁史与上一年漏诊的概率较大，与医保状况、职业、收入和人口状况无关。
IntroductionRates of non-access to needed medical services are elevated among uninsured and sociodemographic subpopulations. Clinical depression is associated with comorbid medical illness and reduced treatment adherence. The purpose of this study was to examine whether prior depression predicts missed needed medical care independent of health insurance status and socioeconomic and demographic characteristics.MethodsData were from a cross-sectional representative sample of adult New York City residents, surveyed through the 2009 (n=9,900) and 2010 (n=8,622) annual Community Health Survey. Logistic regression was used to evaluate the association of lifetime depression with missed needed medical care in the past year, with stratification by health insurance status and adjustment for socioeconomic characteristics. Analyses were performed in 2014.ResultsPrior depression was associated with missed needed medical care among both insured (OR=1.9, 95% CI=1.7, 2.2) and uninsured adults (OR=1.8, 95% CI=1.3, 2.4). Missed needed care report was associated with uninsured status (OR=3.6, 95% CI=3.1, 4.0), controlling for employment, income, and demographics.ConclusionsPrior depression corresponded to greater probability of missed needed medical care report in the previous year, independent of health insurance status, employment, income, and demographics.