The relationship of health professional shortage areas to health status. Implications for health manpower policy.
The relationship of health professional shortage areas to health status. Implications for health manpower policy.
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DOI：
10.1001/archfami.4.8.681
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发表时间：
1995-08-01
期刊：
影响因子：
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通讯作者：
Mainous, A G 3rd
中科院分区：
文献类型：
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作者：
Kohrs, F P;Mainous, A G 3rd
目的：比较卫生专业人员短缺地区成年居民与非卫生专业人员短缺地区成年居民的健康状况。设计：随机数字拨号电话调查。受访者随后按其居住的县分为居住在HPSA或非HPSA。参与者：居住在肯塔基州的470名成年人（18岁或以上）。主要结果测量：健康状况由医疗结果研究20项简短健康调查的六个分量表测量。结果：在多元回归分析中控制了人口统计学变量，高满意度人群和非高满意度人群在社会、心理健康和疼痛亚量表上存在显著差异。在身体、社会、心理健康、健康感知和疼痛亚量表上观察到年龄和hpsa与健康状况之间的相互作用。在按年龄（18 - 44岁，45 - 64岁，或65岁或以上）分层后，除最年轻的年龄层外，所有人的健康状况都与hpv指定区域较差相关。老年人健康状况最差。结论：卫生专业人员短缺地区与老年人健康状况较差有关。未来的政策可能需要侧重于增加获得初级保健服务的机会，而且还需要增加可能促进高保健服务地区老年居民更好健康状况的特定类型的服务。
OBJECTIVE: To compare the health status of adult residents of health professional shortage areas (HPSAs) with adult residents of non-HPSAs.DESIGN: A random-digit dialing telephone survey. Respondents were subsequently classified by their county of residence as residing in an HPSA or non-HPSA.PARTICIPANTS: A sample of 470 adults (18 years or older) living in Kentucky.MAIN OUTCOME MEASURES: Health status was measured by the Medical Outcomes Study 20-Item Short-Form Health Survey's six subscales.RESULTS: Controlling for demographic variables in the multiple regression analysis, there were significant differences between HPSAs and non-HPSAs for the social, mental health, and pain subscales. An interaction between age and HPSAs in relation to health status was observed for the physical, social, mental health, health perception, and pain subscales. After stratification by age (18 to 44 years, 45 to 64 years, or 65 years or older), HPSA-designated areas were associated with poorer health status in all but the youngest age strata. Elders in HPSAs had the poorest health status.CONCLUSIONS: Health professional shortage areas are associated with poorer health status in the older segments of the adult population. Future policy may need to focus on increasing access not only to primary care services but also to specific types of services that may promote better health status of elderly residents of HPSAs.