Sexual minorities in England have poorer health and worse health care experiences: a national survey.
Sexual minorities in England have poorer health and worse health care experiences: a national survey.
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DOI：
10.1007/s11606-014-2905-y
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发表时间：
2015-01
影响因子：
5.7
通讯作者：
Roland, Martin
中科院分区：
文献类型：
--
作者：
Elliott, Marc N.;Kanouse, David E.;Burkhart, Q.;Abel, Gary A.;Lyratzopoulos, Georgios;Beckett, Megan K.;Schuster, Mark A.;Roland, Martin
性少数群体的健康和保健最近被确定为卫生研究和政策的优先事项。将性少数群体的健康和医疗保健经验与同性异性恋者进行比较，调整年龄，种族/民族和社会经济地位。2009/2010年英国全科医学患者调查观察数据的多变量分析。这项调查邮寄给了556万随机抽样的在国家卫生服务全科诊所注册的成年人（占英格兰成年人口的99%）。总共有2，169，718人做出了回应（回应率为39%），其中包括27，497名自称为同性恋或双性恋的人。两项健康状况指标（一般/较差的总体自评健康状况和自我报告存在长期心理状况）和四项不良患者体验指标（对医生不信任或没有信心，医生沟通差/非常差，护士沟通差/非常差，对整体护理相当/非常不满意）。性少数群体报告长期存在心理或情感问题的可能性是异性恋者的两到三倍（年龄调整后，异性恋者占5.2%，男同性恋者占10.9%，双性恋者占15.0%;异性恋者占6.0%，女同性恋者占12.3%，双性恋者占18.8%; p < 0.001）。性少数群体也更有可能报告健康状况一般/不佳（调整后的异性恋者占19.6%，男同性恋者占21.8%，双性恋者占26.4%;异性恋者占20.5%，女同性恋者占24.9%，双性恋者占31.6%; p < 0.001）。根据社会人口特征和健康状况进行调整后，性少数群体报告初级保健四个方面的不良经历的可能性比异性恋者高出约1.5倍。总体差异很少反映出性少数群体集中在低绩效做法中。性少数群体的健康状况较差，医疗保健经历也较差。应努力承认性少数群体的需要并改善他们的经历。检查患者的性取向体验差异可以为这些努力提供信息。本文的在线版本（doi：10.1007/s11606-014-2905-y）包含补充材料，可供授权用户使用。
The health and healthcare of sexual minorities have recently been identified as priorities for health research and policy. To compare the health and healthcare experiences of sexual minorities with heterosexual people of the same gender, adjusting for age, race/ethnicity, and socioeconomic status. Multivariate analyses of observational data from the 2009/2010 English General Practice Patient Survey. The survey was mailed to 5.56 million randomly sampled adults registered with a National Health Service general practice (representing 99 % of England’s adult population). In all, 2,169,718 people responded (39 % response rate), including 27,497 people who described themselves as gay, lesbian, or bisexual. Two measures of health status (fair/poor overall self-rated health and self-reported presence of a longstanding psychological condition) and four measures of poor patient experiences (no trust or confidence in the doctor, poor/very poor doctor communication, poor/very poor nurse communication, fairly/very dissatisfied with care overall). Sexual minorities were two to three times more likely to report having a longstanding psychological or emotional problem than heterosexual counterparts (age-adjusted for 5.2 % heterosexual, 10.9 % gay, 15.0 % bisexual for men; 6.0 % heterosexual, 12.3 % lesbian and 18.8 % bisexual for women; p < 0.001 for each). Sexual minorities were also more likely to report fair/poor health (adjusted 19.6 % heterosexual, 21.8 % gay, 26.4 % bisexual for men; 20.5 % heterosexual, 24.9 % lesbian and 31.6 % bisexual for women; p < 0.001 for each). Adjusted for sociodemographic characteristics and health status, sexual minorities were about one and one-half times more likely than heterosexual people to report unfavorable experiences with each of four aspects of primary care. Little of the overall disparity reflected concentration of sexual minorities in low-performing practices. Sexual minorities suffer both poorer health and worse healthcare experiences. Efforts should be made to recognize the needs and improve the experiences of sexual minorities. Examining patient experience disparities by sexual orientation can inform such efforts. The online version of this article (doi:10.1007/s11606-014-2905-y) contains supplementary material, which is available to authorized users.
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8.4
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