Association between non-communicable disease multimorbidity and health care utilization in a middle-income country: population-based study
Association between non-communicable disease multimorbidity and health care utilization in a middle-income country: population-based study
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DOI：
10.1016/j.puhe.2017.11.014
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发表时间：
2018-02-01
期刊：
影响因子：
5.2
通讯作者：
Terzic-Supic, Z.
中科院分区：
文献类型：
--
作者：
Jankovic, J.;Mirkovic, M.;Terzic-Supic, Z.
目的：目的是分析塞尔维亚共和国非传染性疾病患者在利用保健服务（全科医生和医院）方面可能存在的性别不平等，特别是在多种疾病方面。研究设计：本研究是一项基于人群的横断面调查。方法：对2013年塞尔维亚国家健康调查的13,765名年龄≥ 20岁的成年人进行二次分析。进行多变量Logistic和线性回归分析，以评估非传染性疾病和卫生保健utilization.Results之间的关联：在30.2%的总样本中存在多发病。非传染性疾病数量的增加与小学和中学的利用率提高有关。（男性和女性接受全科医生就诊的比值比[OR]分别为3.17和3.14;两种性别的全科医生就诊次数的非标准化系数[B]均为0.33）和二级卫生保健服务在塞尔维亚（男性住院的OR为2.45，女性为1.97;男性住院过夜次数的B为1.62，女性为0.97）。我们的研究提供了强有力的证据，表明非传染性疾病数量的增加与塞尔维亚医疗保健服务利用率的提高显著相关。有必要采取明智、果断和综合的护理干预措施，以有效管理非传染性疾病及其风险因素。有必要进一步研究，特别强调卫生系统在满足这类病人需要方面的作用。(C)2017年皇家公共卫生学会。由爱思唯尔有限公司出版。保留所有权利。
Objective: The objective was to analyze possible inequalities by gender in the utilization of health services (general practitioner [GP] and hospital), among people with non communicable diseases (NCDs) in the Republic of Serbia, with special reference to multi morbidity. In addition, we examined the prevalence patterns of NCDs by sociodemographic characteristics of the population.Study design: This study is a population-based, cross-sectional survey.Methods: A secondary analysis from the 2013 Serbian National Health Survey included 13,765 adults aged >= 20 years. Multivariable logistic and linear regression analyses were performed to assess the association between NCDs and health care utilization.Results: Multimorbidity was present in 30.2% of the total sample. An increased number of NCDs was associated with a higher utilization of both primary (odds ratio [OR] for having any GP visit is 3.17 in males and 3.14 in females; unstandardized coefficient [B] for number of GP visits is 0.33 for both gender) and secondary health care services (OR for having any hospitalization is 2.45 in males and 1.97 in females; B for number of overnight stays in hospital is 1.62 in males and 0.97 in females) in Serbia.Conclusions: Our study provided strong evidence that an increased number of NCDs was significantly associated with a higher utilization of health care services in Serbia. There is a need for wise, decisive, and integrated care interventions for effective management of NCDs and their risk factors. Further research is necessary with special emphasis on the role of the health system in satisfying needs of such patients. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.