Access to health care for people with multiple sclerosis
Access to health care for people with multiple sclerosis
复制标题
DOI：
10.1177/1352458506071306
复制
发表时间：
2007-05-01
影响因子：
5.8
通讯作者：
Hooglin, D. C.
中科院分区：
文献类型：
--
作者：
Minden, S. L.;Frankel, D.;Hooglin, D. C.
Sonya Slifka纵向多发性硬化症（MS）研究遵循约2000名MS患者的人群队列，研究人口统计学和临床特征，卫生服务的使用和成本，提供者和治疗特征，神经学，经济学和心理社会结局。我们检查了获得医疗保健的关键指标，发现大多数参与者都有医疗保险，通常的护理来源，并获得专业护理。然而，3.8%的人没有医疗保险，应用抽样权重，相当于美国人群中约7000名MS患者。即使有保险，基于人口的估计表明，大量MS患者的计划不支付处方药，限制他们获得专家，并限制他们对医院和提供者的选择。约9%的样本（相当于15 800名MS患者）没有通常的MS护理来源; 11.8%或17 300人没有通常的一般健康护理来源; 31%或57 400人没有看到他们或他们的医生希望他们看到的专家。此外，10.5%或19400人报告难以获得处方药，4.1%或7600人在获得医疗保健方面遇到障碍，2.4%或4500人无法获得所需的心理健康服务。最后，自付医疗保健支出是一般人口的两倍。三分之二的研究参与者（代表近70000人）选择他们的MS护理提供者，因为他们是神经学家或MS专家，创造了几乎肯定超过目前供应的需求。
The Sonya Slifka Longitudinal Multiple Sclerosis (MS) Study follows a population-based cohort of approximately 2000 people with MS to study demographic and clinical characteristics, use and cost of health services, provider and treatment characteristics, neurological, economic, and psychosocial outcomes. We examined key indicators of access to health care and found that the majority of participants had health insurance, a usual source of care, and access to specialty care. Nevertheless, 3.8% did not have health insurance which, with application of sampling weights, corresponds to approximately 7000 people with MS in the US population. Even with insurance, population-based estimates indicated that substantial numbers of people with MS have plans that pay nothing toward prescription medication, limit their access to specialists, and restrict their choice of hospitals and providers. Some 9% of the sample, corresponding to 15 800 people with MS, did not have a usual source of MS care; 11.8% or 17 300 people did not have a usual source of general health care; and 31% or 57 400 people did not see the specialists that they or their physicians wanted them to see. Further, 10.5% or 19 400 people reported difficulty obtaining prescription medication, 4.1% or 7600 people encountered obstacles accessing medical care, and 2.4% or 4500 people could not obtain the mental health services they needed. Finally, out-of-pocket health care expenditures were twice those found for the general population. Two-thirds of study participants (representing almost 70000 people) chose their MS care providers because they were neurologists or MS specialists, creating a demand that almost certainly exceeds current supply.