Prevalence and Determinants of Difficulty in Accessing Medical Care in US Adults
Prevalence and Determinants of Difficulty in Accessing Medical Care in US Adults
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DOI：
10.1016/j.amepre.2021.03.026
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发表时间：
2021-09-17
影响因子：
5.5
通讯作者：
Virani, Salim S.
中科院分区：
文献类型：
--
作者：
Al Rifai, Mahmoud;Mahtta, Dhruv;Virani, Salim S.
导言：确保充分获得保健服务对于及时提供预防服务至关重要。重要的是评估在美国总人口和高危慢性病患者中获得医疗保健困难的流行程度和决定因素。方法：该研究利用了2016-2019年行为风险因素监测系统的横断面数据，这是一项针对18岁以上成年人的全国代表性电话调查。评估了与接受医疗服务困难相关的患病率和社会人口特征，包括美国各州的地区差异。结果：就诊困难的总体发生率为14%，高血压患者为15%，糖尿病患者为15%，动脉粥样硬化性心血管疾病患者为17%。年龄18-34岁，高中以下学历，家庭年收入=这些社会人口特征中的3个。美国各州在获得医疗服务的困难分布上存在地区差异，总人口的中位数为13.6% (IQR=11.3%-15.9%)：生活在没有扩大医疗补助计划的州的中位数为16.3% (IQR=14.1%-19.0%)，而生活在扩大医疗补助计划的州的中位数为12.7% (IQR=10.9%-15.6%) （p=0.01）。结论：总共有七分之一的成年人报告难以获得医疗服务。这一患病率接近四分之一，具有与难以获得医疗保健有关的bb0 = 3社会人口特征。在获得医疗保健的困难分布方面存在地区差异，特别是生活在没有扩大医疗补助计划的州的个人。由爱思唯尔公司代表美国预防医学杂志出版。
Introduction: Ensuring adequate access to health care is essential for timely delivery of preventive services. It is important to evaluate the prevalence and determinants of difficulty in accessing medi-cal care in the overall U.S. population and among those with high-risk chronic conditions.Methods: The study utilized cross-sectional data from the 2016-2019 Behavioral Risk Factor Sur-veillance System, a nationally representative telephone-based survey of adults aged >= 18 years. The prevalence and sociodemographic characteristics associated with difficulty in receiving medical care were assessed, including regional variations across U.S. states.Results: The prevalence of difficulty in accessing medical care was 14% overall, 15% among those with hypertension, 15% among those with diabetes mellitus, and 17% among those with atherosclerotic cardiovascular disease. Age 18-34 years, having less than high school educa-tion, having annual household income = 3 of these sociodemographic characteristics. There was regional variation across the U.S. states in the distribution of difficulty in accessing medical care with a median of 13.6% (IQR=11.3%-15.9%) for the overall population: 16.3% (IQR=14.1%-19.0%) among those liv-ing in states without Medicaid expansion versus 12.7% (IQR=10.9%-15.6%) among those liv-ing in states with Medicaid expansion (p=0.01).Conclusions: In total, 1 in 7 adults report difficulty in accessing medical care. This prevalence is nearly 1 in 4 adults with >= 3 sociodemographic characteristics related to difficulty in accessing med-ical care. There are regional variations in the distribution of the difficulty in accessing medical care, especially among individuals living in states that have not undergone Medicaid expansion. Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.