THE EFFECTS OF TRAVEL BARRIERS AND AGE ON THE UTILIZATION OF ALCOHOLISM-TREATMENT AFTERCARE
THE EFFECTS OF TRAVEL BARRIERS AND AGE ON THE UTILIZATION OF ALCOHOLISM-TREATMENT AFTERCARE
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DOI：
10.3109/00952999509002705
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发表时间：
1995-01-01
影响因子：
2.7
通讯作者：
COOK, CAL
中科院分区：
文献类型：
--
作者：
FORTNEY, JC;BOOTH, BM;COOK, CAL
目的：本研究的目的是确定是否地理可及性（结合其他病人的特点）减少参与酒精中毒善后处理的可能性。研究方法：确定了4，621名美国男性退伍军人的样本，这些退伍军人从退伍军人事务部33个住院酒精依赖治疗项目之一的门诊预约中出院。获得每例患者的门诊记录，以确定出院后是否使用了善后服务。二元选择分析被用来模拟决定进入善后处理的功能，旅行距离，年龄，婚姻状况，种族，疾病的严重程度，和城市化。结果：旅行障碍显着减少善后参与，特别是老年人和农村退伍军人。年轻和年长的退伍军人都不太可能保持他们的善后任命比中年退伍军人。已婚患者比未婚患者更有可能利用门诊服务。种族地位、疾病严重程度和城市规模都对预约就诊的可能性产生负面影响。结论：从这项分析中获得的结果可以有效地用于识别哪些患者不太可能进入酒精中毒治疗后的护理。出院计划的病人在风险预约不遵守应给予特别关注，因为善后已被证明可以改善治疗效果。此外，由于酒精中毒治疗减少了对其他医疗服务的利用，促进护理的连续性应有助于降低为酒精中毒患者提供医疗保健的总体成本。
Objective: The objective of this research was to ascertain whether geographical accessibility (in conjunction with other patient characteristics) reduced the probability of participating in alcoholism aftercare treatment. Methods: A sample of 4,621 United States male veterans discharged with an outpatient appointment from one of 33 Department of Veterans Affairs inpatient Alcohol Dependency Treatment Programs was identified. The outpatient records of each patient were obtained to determine whether aftercare services were utilized following discharge. Binary choice analysis was used to model the decision to enter aftercare treatment as a function of travel distance, age, marital status, ethnicity, severity of illness, and urbanization. Results: Travel barriers significantly reduced aftercare participation, especially for elderly and rural veterans. Both younger and older veterans were less likely to keep their aftercare appointment than middle-aged veterans. Married patients were more likely to utilize outpatient services than unmarried patients. Ethnic status, severity of illness, and urban size ail negatively affected the likelihood of appointment attendance. Conclusions: The results obtained from this analysis can be effectively used to identify which patients are not likely to enter aftercare alcoholism treatment. The discharge plans of patients at risk for appointment noncompliance should be given special attention since aftercare has been shown to improve treatment outcome. Moreover, because alcoholism treatment reduces the utilization of other medical services, promoting continuity of care should help lower the overall costs of providing health care to alcoholic patients.