Hospitalisation rates for ambulatory care sensitive conditions for persons with and without an intellectual disability-a population perspective
Hospitalisation rates for ambulatory care sensitive conditions for persons with and without an intellectual disability-a population perspective
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DOI：
10.1111/j.1365-2788.2010.01311.x
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发表时间：
2010-09-01
影响因子：
3.6
通讯作者：
Colantonio, A.
中科院分区：
文献类型：
--
作者：
Balogh, R.;Brownell, M.;Colantonio, A.
背景有证据表明，智力残疾（ID）的人面临的障碍，初级保健，然而，这还没有得到广泛的研究，在人口水平。门诊护理敏感疾病的住院率被用作获得初级保健和初级保健质量的指标。该研究的目的是比较住院率的门诊护理敏感的条件之间的人与ID在一个公共保险population.MethodsPersons与ID之间的加拿大省的一般人口在1999年和2003年。使用适用于ID患者的条件列表，计算并比较了ID患者和未ID患者的门诊护理敏感性条件的住院率。回归模型用于调整年龄、性别和居住地。住院率的具体条件进行了比较，控制疾病患病率的差异，在possibly.ResultsPersons与ID一致住院的门诊护理敏感的条件下，在较高的利率比人没有ID. Between 1999年和2003年的调整率比（RR）为6.1 [95%置信区间（CI）= 5.6，6.7]。在30-39岁之间（RR = 13.1; 95% CI = 10.6，16.2）和城市地区居民（RR = 7.0; 95% CI = 6.2，7.9）中，有身份证的人与无身份证的人的比率最高。癫痫和精神分裂症的住院率分别为54和15倍，与人相比，没有ID. Rate比率糖尿病和哮喘仍然显着控制后，人口患病率这些diseases.ConclusionsThe人与没有ID之间的住院率的巨大差异是一个指标，初级保健不足，这个弱势群体。通过为ID患者提供专门的门诊方案，减少门诊护理敏感疾病住院的数量，可能会改善健康状况，提高生活质量并节省费用。未来的研究应包括潜在的重要因素，如疾病的严重程度，社会经济变量和措施的卫生服务组织的分析。国际比较门诊护理敏感条件的住院率可以指出的好处和局限性的卫生服务政策方向，通过不同的国家。
BackgroundThere is evidence that persons with an intellectual disability (ID) face barriers to primary care; however, this has not been extensively studied at the population level. Rates of hospitalisation for ambulatory care sensitive conditions are used as an indicator of access to, and quality of, primary care. The objective of the study was to compare hospitalisation rates for ambulatory care sensitive conditions between persons with and without an ID in a publicly insured population.MethodsPersons with an ID were identified among the general population of a Canadian province between 1999 and 2003. Using a list of conditions applicable to persons with an ID, rates of hospitalisations for ambulatory care sensitive conditions for persons with and without an ID were calculated and compared. Regression models were used to adjust for age, sex and place of residence. Hospitalisation rates for specific conditions were also compared, controlling for differences in disease prevalence where possible.ResultsPersons with an ID were consistently hospitalised for ambulatory care sensitive conditions at a higher rate than persons without an ID. Between 1999 and 2003 the adjusted rate ratio (RR) was 6.1 [95% confidence interval (CI) = 5.6, 6.7]. Rate ratios were highest when comparing persons with, to persons without, an ID between the ages of 30-39 (RR = 13.1; 95% CI = 10.6, 16.2) and among urban area dwellers (RR = 7.0; 95% CI = 6.2, 7.9). Hospitalisation rates for epilepsy and schizophrenic disorders were, respectively, 54 and 15 times higher for persons with compared with persons without an ID. Rate ratios for diabetes and asthma remained significant after controlling for the population prevalence of these diseases.ConclusionsThe large discrepancy in rates of hospitalisation between persons with and without an ID is an indicator of inadequate primary care for this vulnerable population. Decreasing the number of ambulatory care sensitive condition hospitalisations through specialised outpatient programmes for persons with an ID would potentially lead to better health, improved quality of life and cost savings. Future research should include potentially important factors such as disease severity, socio-economic variables and measures of health service organisation in the analysis. International comparisons of ambulatory care sensitive condition hospitalisation rates could point to the benefits and limitations of the health service policy directions adopted by different countries.