Adolescent Primary Care Visit Patterns
Adolescent Primary Care Visit Patterns
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DOI：
10.1370/afm.1188
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发表时间：
2010-11-01
影响因子：
4.4
通讯作者：
Parker, Emily D.
中科院分区：
文献类型：
--
作者：
Nordin, James D.;Solberg, Leif I.;Parker, Emily D.
青少年被推荐接受许多临床预防保健服务，但大多数青少年是否有足够的预防保健服务次数来接受这些服务却知之甚少。我们想测量通过私人保险或政府计划投保的青少年预防性与非预防性保健访问的频率。明尼苏达州的健康计划，约有700，000名成员所有研究患者的年龄为11至18岁，从1998年1月1日至2007年12月31日，我们的结果测量是预防性和非预防性护理访视率结果三分之一的青少年连续登记4年或更长时间，从13岁到17岁没有预防性护理访视，另外40%的人只有一次这样的就诊。在所有年龄组中，非预防性保健就诊更频繁，11岁时平均每年约1次，17岁时上升到每年约15次。政府保险和商业保险之间的比率差异很小，女孩比男孩有更多的预防性保健访问和更多的非预防性保健访问结论大多数青少年很少来预防性保健访问，但更多的是非预防性保健访问我们建议在青少年中使用相同的方法进行预防性保健，在成人中使用不错过机会范例青少年的所有就诊都应被视为提供预防保健服务的机会，应建立系统使之成为可能，即使在与临床医生短暂接触的忙碌实践中也是如此
PURPOSE Many clinical preventive care services are recommended for adolescents Little is known about whether most adolescents have a sufficient number of preventive care services visits over time to receive those services We wanted to measure how frequently adolescents who are insured either through private insurance or government programs have preventive vs nonpreventive care visitsMETHODS We conducted a retrospective descriptive analysis based on claims data from a large health plan in Minnesota with about 700,000 members All study patients were aged 11 to 18 years between January 1, 1998, and December 31 2007 Our outcome measure was rates of preventive and nonpreventive care visitsRESULTS One third of adolescents with 4 or more years of continuous enrollment had no preventive care visits from age 13 through 17 years, and another 40% had only a single such visit Nonpreventive care visits were more frequent in all age groups, averaging about 1 per year at age 11 years, climbing to about 1 5 per year at age 17 years Differences in rates between government insurance and commercial insurance were small In older adolescence, girls had more preventive care visits and more nonpreventive care visits than did boysCONCLUSIONS Most adolescents come in infrequently for preventive care visits but more often for nonpreventive care visits We recommend using the same approach in adolescence for preventive care that is being used in adults the no-missed opportunities paradigm All visits by adolescents should be viewed as an opportunity to provide preventive care services, and systems should be set up to make that possible, even in busy practices with short encounters with a clinician