Delayed medical care after diagnosis in a US national probability sample of persons infected with human immunodeficiency virus
Delayed medical care after diagnosis in a US national probability sample of persons infected with human immunodeficiency virus
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DOI：
10.1001/archinte.160.17.2614
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发表时间：
2000-09-25
影响因子：
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通讯作者：
Zierler, S
中科院分区：
文献类型：
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作者：
Turner, BJ;Cunningham, WE;Zierler, S
目的：为了确定卫生保健和病人的因素与延迟初步医疗照顾人类免疫缺陷病毒（HIV）infection.Design：调查的一个国家的概率样本的人与艾滋病毒在照顾。设置医疗实践在美国连续患者：队列A（N=1540）被诊断为1993年2月，并在照顾3年内;队列B（N=1960）于1995年2月确诊，并在确诊后1年内接受治疗。主要结果测量：延迟3或6个月以上。结果：延迟3个月以上的发生率为队列A的29%（中位数，1年）和队列B的17%。在诊断时接受常规治疗可减少延迟，队列A中校正的比值比（OR）为0.61（95%置信区间[CI]，0.48-0.77），队列B中为0.70（95% CI，0.50-0.99）。与私人保险相比，诊断时的医疗补助覆盖率显示出较低的延迟调整OR（队列A：调整OR，0.52; 95% CI，0.30-0.92;队列B：调整OR，0.48; 95% CI，0.27-0.85）。与白人相比，拉丁裔的延迟调整OR分别高出53%和95%（P
Objective: To identify health care and patient factors associated with delayed initial medical care for human immunodeficiency virus (HIV) infection.Design: Survey of a national probability sample of persons with HIV in care.Settings Medical practices in the contiguous United States.Patients: Cohort A (N=1540) was diagnosed by February 1993 and was in care within 3 years; cohort B (N=1960) was diagnosed by February 1995 and was in care within 1 year of diagnosis.Main Outcome Measure: More than 3- or 6-month delay.Results: Delay of more than 3 months occurred for 29% of cohort A (median, 1 year) and 17% of cohort B. Having a usual source of care at diagnosis reduced delay, with adjusted odds ratios (ORs) of 0.61 (95% confidence interval [CI], 0.48-0.77) in cohort A and 0.70 (95% CI, 0.50-0.99) in cohort B. Medicaid coverage at diagnosis showed lower adjusted ORs of delay compared with private insurance (cohort A: adjusted OR, 0.52; 95% CI, 0.30-0.92; cohort B: adjusted OR, 0.48; 95%, CI, 0.27-0.85). Compared with whites, Latinos had 53%, and 95% higher adjusted ORs of delay (P