Use of outpatient medical care by headache patients in Germany: a population-based cross-sectional study
Use of outpatient medical care by headache patients in Germany: a population-based cross-sectional study
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DOI：
10.1186/s10194-020-01099-1
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发表时间：
2020-05-11
影响因子：
7.4
通讯作者：
Foerderreuther, Stefanie
中科院分区：
文献类型：
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作者：
Mueller, Britta;Dresler, Thomas;Foerderreuther, Stefanie
背景 需要专业医疗保健的头痛患者通常不会利用现有的护理，并且影响头痛特定医生咨询的因素尚不清楚。本研究的目的是 (1) 评估自我报告的头痛特定医生咨询情况；(2) 确定头痛相关和社会人口学预测因素。方法 对德国 14 岁以上普通人群的随机样本数据进行分析（N = 2461）。进行多变量二元逻辑回归以确定预测医生咨询的简约模型。结果 50.7% 的头痛参与者报告在其一生中至少接受过一次针对头痛的医生咨询。其中，53.6% 的人因头痛看过一位医生，26.1% 的人看过两次医生，20.3% 的人因头痛看过两位以上的医生。随着每月头痛天数 (HDM) [(参考 HDM < 1) HDM 1-3 (OR = 2.29)、HDM 4-14 (OR = 2.41) 和 HDM >= 15 (OR = 4.83)] 和头痛影响测试分数 (HIT-6) [(参考“没有或很少影响”) 中度影响 (OR = 1.74)、实质性影响] 的增加，就诊的几率增加（OR = 3.01）和严重影响（OR = 5.08）]。中年参与者比年轻和年长参与者更有可能接受咨询[（参考14-34岁）35-54岁（OR = 1.90）、55-74岁（OR = 1.96）、> = 75岁（OR = 1.02）]。自营职业者接受医生咨询的几率低于受雇体力劳动者（OR = 0.48）。居住环境（农村与城市）对咨询频率没有影响。结论 结果表明，除了与负担相关的因素（头痛频率；头痛影响）之外，医疗保健利用模式还受到患者职业状况和年龄的影响。需要进一步的研究来分析较低的咨询率是否意味着个体经营者有较高的慢性化风险，或者他们对头痛有更有效的自我管理策略。
Background Headache sufferers in need of professional health care often do not utilize the care available, and factors influencing headache-specific physician consultation are not yet understood. Objectives of this study are (1) to assess self-reported headache-specific physician consultations and (2) to identify headache-related and sociodemographic predictors. Methods Data of a random sample of the general population in Germany aged >= 14 years were analyzed (N = 2461). A multivariate binary logistic regression was conducted to identify a parsimonious model to predict physician consultation. Results 50.7% of the participants with headache reported at least one headache-specific physician consultation during lifetime. Of these, 53.6% had seen one, 26.1% two, and 20.3% more than two physicians because of their headaches. The odds of physician consultation increased with the number of headache days per month (HDM) [(reference HDM < 1) HDM 1-3 (OR = 2.29), HDM 4-14 (OR = 2.41), and HDM >= 15 (OR = 4.83)] and increasing Headache Impact Test score (HIT-6) [(reference "no or little impact") moderate impact (OR = 1.74), substantial impact (OR = 3.01), and severe impact (OR = 5.08)]. Middle-aged participants were more likely to have consulted than younger and older ones [(reference 14-34 years) 35-54 years (OR = 1.90), 55-74 years (OR = 1.96), >= 75 years (OR = 1.02)]. The odds of physician consultation among self-employed subjects were lower than among employed manual workers (OR = 0.48). The living environment (rural versus urban) did not have an influence on the consultation frequency. Conclusion The results indicate that apart from burden-related factors (headache frequency; headache impact), health care utilization patterns are also influenced by patients' occupational status and age. Further research is needed to analyze whether the lower consultation rate means that the self-employed have a higher risk of chronification or that they have more effective self-management strategies regarding headache.