Psychological distress and the decision to seek medical care among a Medicare population.
Psychological distress and the decision to seek medical care among a Medicare population.
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医疗保险人群的心理困扰和寻求医疗护理的决定。
DOI：
10.1097/00005650-198911000-00007
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发表时间：
1989
期刊：
影响因子：
3
通讯作者：
Hurwicz,ML
中科院分区：
文献类型：
--
作者：
Berkanovic,E;Hurwicz,ML
尽管有许多研究将心理困扰与医疗保健需求联系起来，但很少有研究探讨老年人之间的这种关系。然而，这个问题很重要，部分原因是有人认为痛苦可能会导致一些人寻求不必要的医疗护理。因此，老年人寻求不必要的护理对医疗保险的财务影响是公众关注的问题。本研究提供了对 1,009 名 Medicare 受益人样本中心理困扰对寻求医疗护理影响的前瞻性调查结果。在对心理困扰等进行评估的基线访谈之后，受访者在一年内接受了六次重新访谈。在每次访谈中报告疾病发作的受访者都会被问及一系列有关他们如何应对该事件的问题。本分析探讨了一系列变量（包括心理困扰）对受访者被询问的每个事件寻求护理的决定的影响。它还研究了心理困扰对受访者在研究年内要求就诊的总次数的影响。最后，由于由 22 名老年病学家组成的小组对受访者报告的事件是否应导致就医进行了评估，因此分析了心理困扰对这些受访者就诊的医疗必要性的影响。分析发现心理困扰与这些结果之间没有任何关系。因此，在这些受访者中，心理困扰似乎对看医生的频率或疾病发作时就诊的医疗必要性没有任何影响。
Although there have been a number of studies linking psychological distress to the demand for medical care, few studies have examined this relationship among the aged. The issue is important, however, partly because it has been suggested that distress might cause some individuals to seek unneeded medical care. The financial impact of the aged seeking unneeded care on Medicare is, thus, a matter of public concern. This study presents results from a prospective investigation of the impact of psychological distress on the seeking of medical care among a sample of 1,009 Medicare recipients. Following a baseline interview that assessed, among other things, psychological distress, the respondents were reinterviewed six times over the course of one year. Respondents reporting episodes of illness at each interview were asked a series of questions regarding how they responded to the episode. The present analysis examines the impact of a series of variables, including psychological distress, on the decision to seek care for each of the episodes about which the respondent was queried. It also examines the impact of psychological distress on the total number of physician visits requested by the respondent over the study year. Finally, since a panel of 22 geriatricians rated whether or not the episodes reported by the respondents should have resulted in a physician visit, the impact of psychological distress on the medical necessity of the visits made by these respondents is analyzed. The analyses found no relationship between psychological distress and any of these outcomes. Thus, it does not appear that, among these respondents, psychological distress has any impact either on the frequency of physician visits or the medical necessity of visits made for episodes of illness.