Rural-urban disparities in health-related quality of life within disease categories of veterans
Rural-urban disparities in health-related quality of life within disease categories of veterans
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DOI：
10.1111/j.1748-0361.2006.00033.x
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发表时间：
2006-06-01
影响因子：
4.9
通讯作者：
Kazis, Lewis E.
中科院分区：
文献类型：
--
作者：
Weeks, William B.;Wallace, Amy E.;Kazis, Lewis E.
背景：与城市退伍军人相比，农村退伍军人的健康相关生活质量较低。目的：确定在检查农村和城市退伍军人的疾病类别时是否存在这些差异。方法：我们获得748,216名退伍军人的调查数据，这些退伍军人目前或预计是退伍军人健康管理局的患者。使用国际疾病分类(ICD)-9CM代码，我们确定这些退伍军人是否患有30种身体健康疾病类别中的任何一种诊断，我们使用邮政编码来确定退伍军人是生活在农村还是城市环境中。我们比较了农村和城市疾病类别的患病率，以及城市和农村与健康相关的生活质量身体健康成分总结得分（PCS）和心理健康成分总结得分（MCS）。研究结果：在农村退伍军人中，体格诊断在大多数疾病类别中更为普遍。对于检查的每种疾病类别，与城市环境相比，生活在农村的退伍军人的PCS显着降低（所有P < 0.001）；农村退伍军人在所有疾病类别中也经历了较低的MCS，尽管差异不大。在控制了社会人口因素后，差异仍然存在。结论：与城市退伍军人相比，在疾病类别中，农村退伍军人患病率较高，身心生活质量得分较低。政策制定者应预见到农村退伍军人对医疗保健的需求会增加，并努力满足这一需求。
Context: Compared to their urban counterparts, rural veterans have been found to have lower health-related quality of life. Purpose: To determine whether these disparities persist when examining disease categories of rural and urban veterans. Methods: We obtained survey data on 748,216 veterans who were current or anticipated Veterans Health Administration patients. Using International Classification of Diseases (ICD)-9CM codes, we determined whether these veterans had diagnoses that fell into any of 30 physical health disease categories, and we used ZIP codes to determine whether veterans lived in rural or urban settings. We compared rural to urban prevalence of disease categories as well as urban to rural health-related quality-of-life physical health component summary scores (PCS) and mental health component summary scores (MCS) for each disease category. Findings: Physical diagnoses were significantly more prevalent in the rural veteran population for most disease categories examined. For every disease category examined, PCS were significantly lower for veterans who lived in rural, compared to urban, settings (P < .001 for all); rural veterans also experienced lower MCS for all disease categories although differences were modest. Differences persisted after controlling for sociodemographic factors. Conclusions: Compared to the urban veteran population, within disease categories, the rural veteran population experiences higher disease prevalence and lower physical and mental quality-of-life scores. Policymakers should anticipate greater health care demands from the rural veteran population and work to meet that demand.