Burden of medical illness in drug- and alcohol-dependent persons without primary care
Burden of medical illness in drug- and alcohol-dependent persons without primary care
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DOI：
10.1080/10550490490265307
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发表时间：
2004-01-01
影响因子：
3.7
通讯作者：
Saitz, R
中科院分区：
文献类型：
--
作者：
De Alba, I;Samet, JH;Saitz, R
对于没有初级医疗护理的药物和酒精依赖者的疾病发生频率、严重程度和危险因素知之甚少。我们的目标是评估医疗疾病的负担，确定与身体健康状况较差相关的患者和物质依赖特征，并比较该人群的疾病负担措施。这是通过对入住城市住院戒毒所、没有初级医疗护理的酒精、海洛因或可卡因依赖者进行横断面研究来完成的。这些患者的平均年龄为 35.7 (SD 7.8) 岁； 76% 是男性，46% 是黑人。 45% 的人报告被诊断患有慢性病，80% 的人之前曾住院治疗。年龄调整后的 SF-36 身体成分总结 (PCS) 平均得分低于美国一般人口标准（44.1 vs 50.1；p < 0.001）。在多变量分析中，女性（PCS 评分的调整后平均变化：-3.71 分，p = .002）、使用致幻剂（-3.51，p = 0.013）、海洛因（-2.94，p = 0.008）、其他阿片类药物（-3.20，p = .045）、独居（-3.15，p = .023）、有问题医疗保险（-2.26，p = 0.014）和年龄较大（每年-.22分，p = 0.001）与健康状况较差相关。从这些数据来看，与年龄和性别匹配的美国人口对照相比，没有初级医疗保健的酒精和药物依赖者似乎承受着巨大的医疗疾病负担。虽然该人群的医疗疾病负担的最佳衡量标准尚不清楚，但各种健康措施记录了成瘾者的医疗疾病负担。
Little is known about the frequency, severity, and risk factors for disease in drug- and alcohol-dependent persons without primary medical care. Our aims are to assess the burden of medical illness, identify patient and substance dependence characteristics associated with worse physical health, and compare measures of illness burden in this population. This was accomplished through a cross-sectional study among alcohol-, heroin- or cocaine-dependent persons without primary medical care who were admitted to an urban inpatient detoxification unit. The mean age of these patients was 35.7 (SD 7.8) years; 76% were male and 46% were Black. Forty-five percent reported being diagnosed with a chronic illness, and 80% had prior medical hospitalizations. The mean age-adjusted SF-36 Physical Component Summary (PCS) score was lower than the general U.S. population norm (44.1 vs 50.1; p < 0.001). In multivariable analysis, female gender (adjusted mean change in PCS score: -3.71 points, p = .002), problem use of hallucinogens (-3.51, p = 0.013), heroin (-2.94, p = 0.008), other opiates (-3.20, p = .045), living alone (-3.15, p = .023), having medical insurance (-2.26, p = 0.014) and older age (-.22 points per year, p = 0.001) were associated with worse health. From these data, it seems that alcohol- and drug-dependent persons without primary medical care have a substantial burden of medical illness compared to age- and gender-matched U.S. population controls. While the optimal measure of medical illness burden in this population is unclear, a variety of health measures document this medical illness burden in addicted persons.