Health service utilisation associated with chronic breathlessness: random population sample
Health service utilisation associated with chronic breathlessness: random population sample
复制标题
DOI：
10.1183/23120541.00415-2021
复制
发表时间：
2021-10-01
影响因子：
4.6
通讯作者：
Johnson, Miriam J.
中科院分区：
文献类型：
--
作者：
Currow, David C.;Chang, Sungwon;Johnson, Miriam J.
背景大多数卫生服务利用研究是针对具有特定诊断或人口统计学特征的人群，很少针对特定的慢性症状。本研究的目的是建立人口水平的卫生服务利用率是否增加的人与慢性breathings.Methods进行了横断面分析的南澳大利亚州健康综合调查2017年，多阶段，聚集区，系统抽样调查的成年人的问题是管理面对面的受访者的家。过去3个月内使用医疗服务的自我报告（医疗咨询、急诊、住院）、慢性呼吸困难研究对象为2898人，研究方法包括问卷调查、问卷调查（严重程度、持续时间、改良医学研究理事会（mMRC）呼吸困难量表）和人口统计学资料（49.0%为男性;中位年龄48.0岁（IQR 32.0-63.0）; 64.1%的受教育程度超过学校; 55.4%在工作; 73.5%有门诊接触; 6.3%在过去3个月内住院）。8.8%的受访者报告慢性呼吸困难（mMRC >= 1）。在双变量分析中，与卫生服务接触较多的人年龄较大，超重/肥胖的比例较高，慢性呼吸困难更严重。在多变量分析中，慢性呼吸困难和年龄较大与门诊和住院治疗呈正相关，慢性呼吸困难的人住院时间较长（发病率比2.5; 95%CI 1.4-4.5）。结论慢性呼吸困难的恶化和卫生服务利用率的增加之间存在显着关联。有必要更好地了解引起与保健服务接触的因素。
Background Most health service utilisation studies are of people with specific diagnoses or demographic characteristics, and rarely of specific chronic symptoms. The aim of this study was to establish whether population-level health service utilisation increases in people with chronic breathlessness.Methods A cross-sectional analysis was carried out of the South Australian Health Omnibus Survey 2017, a multi-stage, clustered area, systematic sampling survey of adults where questions are administered face-to-face in respondents' homes. Self-report of health service utilisation in the previous 3 months (medical consultations, emergency department, hospital admission), chronic breathlessness (severity, duration, modified Medical Research Council (mMRC) breathlessness scale) and demographic data were used to predict self-reported health service utilisation.Results A total of 2898 people were included (49.0% male; median age 48.0 years (IQR 32.0-63.0); 64.1% educated beyond school; 55.4% in work; 73.5% had outpatient contact; 6.3% had a hospital admission in the previous 3 months). Chronic breathlessness (mMRC >= 1) was reported by 8.8% of respondents. In bivariable analyses, people with greater contact with health services were older, and a higher proportion were overweight/obese and had more severe chronic breathlessness. In multivariable analyses, chronic breathlessness and older age were positively associated with outpatient care and inpatient care, and people with chronic breathlessness were hospitalised for longer (incidence rate ratio 2.5; 95% CI 1.4-4.5).Conclusion There is a significant association between worse chronic breathlessness and increased health service utilisation. There is a need for greater understanding of factors that initiate contact with health services.