Use of primary and hospital care health services by chronic patients according to risk level by adjusted morbidity groups.
Use of primary and hospital care health services by chronic patients according to risk level by adjusted morbidity groups.
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DOI：
10.1186/s12913-021-07020-z
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发表时间：
2021-10-03
影响因子：
2.8
通讯作者：
Jaime-Sisó MÁ
中科院分区：
文献类型：
--
作者：
Barrio-Cortes J;Soria-Ruiz-Ogarrio M;Martínez-Cuevas M;Castaño-Reguillo A;Bandeira-de Oliveira M;Beca-Martínez MT;López-Rodríguez MC;Jaime-Sisó MÁ
慢性病患者对帮助和护理的需求增加。本研究的目的是根据基于调整发病率组（AMG）的风险水平描述慢性病患者对初级保健（PC）和医院护理（HC）卫生服务的特征和使用，并分析相关因素。横断面描述性观察研究。来自马德里 PC 电子病历 AMG 分类系统分类为慢性病的基本健康领域的患者也被纳入其中。收集了社会人口学、临床护理特征（分为诱发因素或需求因素）和服务利用变量。进行单变量、双变量和简单线性回归分析。该样本包括 9866 名慢性病患者和 8332 名 (84.4%) 使用过医疗服务的人。在这些服务使用者中，63%是女性，平均年龄为55.7岁（SD = 20.8），439人（5.3%）为高风险，1746人（21.2%）为中风险，6041人（73.4%）为低风险。 PC用户为8226人（98.7%），HC用户为4284人（51.4%）。年平均接触电脑次数为13.9次（SD = 15）；与 HC 的平均接触次数为 4.8 次（SD = 6.2）。与两个护理级别的服务利用相关的诱发因素是：年龄（PC 和 HC 的 B 系数 [BC] = 0.03 和 0.018，95% CI = 0.017–0.052 和 0.008–0.028）和西班牙裔（BC = 0.962 和 3.396，95% CI = 0.198–1.726 和 2.722–4.070);需求因素包括：姑息治疗（BC = 10,492和5047；95% CI = 6457–14,526和3098-6995）、高风险（BC = 4631和2730、95% CI = 3022–6241和1.949–3.512)，慢性病数量(BC = 1.291和0.222，95% CI = 1.068–1.51和0.103–0.341)和肿瘤数量(BC = 2.989和4.309，95% CI = 1.659–4.319 和 3.629–4.989)。慢性病患者的特征以及 PC 和 HC 服务利用情况根据其 AMG 风险水平而有所不同。尽管两个级别的护理利用率都很高，但 PC 服务的使用率高于 HC 服务。服务的使用与年龄和原籍国等诱发因素有关，最重要的是，与不动、高风险、需要随访和姑息治疗的慢性疾病的数量和类型等需求因素有关。在线版本包含可在 10.1186/s12913-021-07020-z 获取的补充材料。
Patients with chronic diseases have increased needs for assistance and care. The objective of this study was to describe the characteristics and use of primary care (PC) and hospital care (HC) health services by chronic patients according to risk level based on adjusted morbidity groups (AMG) and to analyze the associated factors. Cross-sectional descriptive observational study. Patients from a basic health area classified as chronically ill by the AMG classification system of the Madrid PC electronic medical record were included. Sociodemographic, clinical-care characteristics (classified as predisposing factors or need factors) and service utilization variables were collected. Univariate, bivariate and simple linear regression analyses were performed. The sample consisted of 9866 chronic patients and 8332 (84.4%) used health services. Of these service users, 63% were women, mean age was 55.7 (SD = 20.8), 439 (5.3%) were high risk, 1746 (21.2%) were medium risk, and 6041(73.4%) were low risk. A total of 8226 (98.7%) were PC users, and 4284 (51.4%) were HC users. The average number of annual contacts with PC was 13.9 (SD = 15); the average number of contacts with HC was 4.8 (SD = 6.2). Predisposing factors associated with services utilization at both care levels were: age (B coefficient [BC] = 0.03 and 0.018, 95% CI = 0.017–0.052 and 0.008–0.028, respectively, for PC and HC) and Spanish origin (BC = 0.962 and 3.396, 95% CI = 0.198–1.726 and 2.722–4.070); need factors included: palliative care (BC = 10,492 and 5047; 95% CI = 6457–14,526 and 3098-6995), high risk (BC = 4631 and 2730, 95% CI = 3022–6241 and 1.949–3.512), number of chronic diseases (BC = 1.291 and 0.222, 95% CI = 1.068–1.51 and 0.103–0.341) and neoplasms (BC = 2.989 and 4.309, 95% CI = 1.659–4.319 and 3.629–4.989). The characteristics and PC and HC service utilization of chronic patients were different and varied according to their AMG risk level. There was greater use of PC services than HC services, although utilization of both levels of care was high. Service use was related to predisposing factors such as age and country of origin and, above all, to need factors such as immobility, high risk, and number and type of chronic diseases that require follow-up and palliative care. The online version contains supplementary material available at 10.1186/s12913-021-07020-z.
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影响因子：
1.9
作者：
Estupinan-Ramirez, Marcos;Tristancho-Ajamil, Rita;Sanchez-Janariz, Hilda
通讯作者：
Sanchez-Janariz, Hilda
影响因子：
2.9
作者：
Monterde, D.;Vela, E.;Perez-Sust, P.
通讯作者：
Perez-Sust, P.
影响因子：
3.7
作者：
Garin N;Olaya B;Perales J;Moneta MV;Miret M;Ayuso-Mateos JL;Haro JM
通讯作者：
Haro JM
影响因子：
3
作者：
Hughes, JS;Averill, RF;Gay, JC
通讯作者：
Gay, JC
影响因子：
3
作者：
Andersen, Ronald Max
通讯作者：
Andersen, Ronald Max