Ambulatory Care Among Young Adults in the United States
Ambulatory Care Among Young Adults in the United States
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DOI：
10.7326/0003-4819-151-6-200909150-00002
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发表时间：
2009-09-15
影响因子：
39.2
通讯作者：
Halterman, Jill S.
中科院分区：
文献类型：
--
作者：
Fortuna, Robert J.;Robbins, Brett W.;Halterman, Jill S.
背景：年轻人是最有可能没有保险的年龄段，也是药物滥用、机动车事故和性传播疾病患病率最高的年龄段，但对他们使用门诊护理的情况知之甚少。目的：描述年轻人的门诊护理特征。设计：来自国家动态医疗调查和国家医院动态医疗调查的横断面数据。地点：以社区和医院为基础的临床。患者：20至29岁的未怀孕的年轻成年人。结果：参保青年人均年就诊次数(2.16[95%CI，2.14~2.19]次)高于未参保者(0.59[CI，0.54~0.67]次)。年轻男性使用门诊医疗服务的年龄低于15至19岁的青少年或30至39岁的老年人(人均年就诊次数分别为1.10、1.65和1.73次)，使用率低于年轻女性(人均年就诊次数分别为1.10次和2.31次)。年轻的黑人和西班牙裔男性的人均年访问量(分别为0.75和0.65)明显低于年轻的白人男性(1.21)。与男性青少年或老年男性相比，年轻男性的预防性护理就诊次数接近一半(人均分别为0.11次、0.24次和0.19次)，而与年轻女性相比(人均0.11次和0.48次年度就诊次数)，年轻男性的预防性护理就诊次数不到四分之一。仅有30.6%的青壮年就诊包括任何预防性咨询，很少有针对伤害预防(2.4%)、心理健康(4.1%)或性传播疾病(2.7%)的咨询。限制：学校诊所不包括在内，咨询可能被漏报。结论：相对于其他人群，青壮年较少使用非卧床医疗服务，很少接受针对其健康最大威胁的预防性服务。需要努力确保适当的预防性护理。
Background: Young adults are the most likely age group to be uninsured and have the highest prevalence of substance abuse, motor vehicle accidents, and sexually transmitted diseases, yet little is known about their use of ambulatory care.Objective: To characterize ambulatory care of young adults.Design: Cross-sectional data from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey.Setting: Community and hospital-based clinics.Patients: Nonpregnant young adults age 20 to 29 years. Measurements: Ambulatory care utilization, types of visits, and preventive care.Results: Insured young adults had more visits (2.16 [95% CI, 2.14 to 2.19] annual visits per capita) than those without insurance (0.59 [CI, 0.54 to 0.67] annual visits per capita). Young men utilized ambulatory medical care less than adolescents age 15 to 19 years or older adults age 30 to 39 years (1.10, 1.65, and 1.73 annual visits per capita, respectively) and had lower rates of utilization than young women (1.10 vs. 2.31 annual visits per capita). Young black and Hispanic men had considerably fewer annual visits per capita (0.75 and 0.65, respectively) than did young white men (1.21). Young men had nearly one half the preventive care visits compared with male adolescents or older men (0.11, 0.24, and 0.19 annual visits per capita, respectively) and less than one quarter the visits compared with young women (0.11 vs. 0.48 annual visits per capita). Only 30.6% of visits by young adults included any preventive counseling, and few encounters included counseling directed toward injury prevention (2.4%), mental health (4.1%), or sexually transmitted diseases (2.7%).Limitation: School-based clinics were not included, and counseling may be underreported.Conclusion: Young adults use less ambulatory medical care relative to other groups and infrequently receive preventive care directed at the greatest threats to their health. Efforts to ensure appropriate preventive care are needed.