Inequalities in receipt of mental and physical healthcare in people with dementia in the UK.
Inequalities in receipt of mental and physical healthcare in people with dementia in the UK.
复制标题
DOI：
10.1093/ageing/afw208
复制
发表时间：
2017-05-01
期刊：
影响因子：
6.7
通讯作者：
Petersen I
中科院分区：
文献类型：
--
作者：
Cooper C;Lodwick R;Walters K;Raine R;Manthorpe J;Iliffe S;Petersen I
英国痴呆症战略优先考虑公平获得精神和身体保健。我们调查了痴呆症患者获得的医疗保健是否存在剥夺或性别不平等，并比较了痴呆症患者和非痴呆症患者获得的医疗保健。我们调查了68,061名社区居住区痴呆症患者和259,337名非痴呆症患者的初级保健记录(2002-13)。我们测试了一些假设，即与来自贫困程度较低地区的患者和男性相比，来自较贫困地区的痴呆症患者接受更多的精神药物治疗，较少的手术咨询，接受年度血压、体重监测和年度审查的可能性较小。只有一半的痴呆症患者接受了有文件记录的年度审查。剥夺与所接受的医疗保健无关。与男性痴呆症患者相比，女性痴呆症患者的手术就诊率(调整后发生率比(IRR)为0.90，95%CI为0.90~0.91)、年度血压监测发生率(调整后IRR为0.96，95%CI为0.95~0.97)和年体重监测率(调整后IRR为0.91，95%CI为0.90~0.93)较低。痴呆症患者男性服用精神药物的可能性低于女性痴呆症患者。与非痴呆组相比，痴呆症患者接受手术咨询的次数更少，至少每年监测他们的体重和血压的可能性也更小。痴呆症患者，特别是女性，似乎接受的初级医疗保健较少，但服用更多的精神药物，这可能会对他们的身体健康产生负面影响。减少这些不平等，改善痴呆症患者获得预防性医疗保健的机会，可以改善痴呆症患者的健康。
UK Dementia Strategies prioritise fair access to mental and physical healthcare. We investigated whether there are inequalities by deprivation or gender in healthcare received by people with dementia, and compared healthcare received by people with and without dementia. we investigated primary care records of 68,061 community dwelling dementia patients and 259,337 people without dementia (2002–13). We tested hypotheses that people with dementia from more deprived areas, and who are women receive more psychotropic medication, fewer surgery consultations, are less likely to receive annual blood pressure, weight monitoring and an annual review, compared with those from less deprived areas and men. only half of people with dementia received a documented annual review. Deprivation was not associated with healthcare received. Compared to men with dementia, women with dementia had lower rates of surgery consultations (adjusted incidence rate ratio (IRR) 0.90, 95% CI 0.90–0.91), of annual blood pressure monitoring (adjusted IRR 0.96, 95% CI 0.95–0.97) and of annual weight monitoring (adjusted IRR 0.91, 95% CI 0.90–0.93). Men with dementia were less likely to be taking psychotropic medication than women with dementia. People with dementia had fewer surgery consultations and were less likely to have their weight and blood pressure monitored at least annually, compared to the non-dementia group. people with dementia, in particular women, appear to receive less primary healthcare, but take more psychotropic medication that may negatively impact their physical health. Reducing these inequalities and improving access of people with dementia to preventative healthcare could improve the health of people with dementia.