GENDER, ALCOHOL, COMORBIDITY, AND USE OF HEALTH SERVICES

性别、酒精、合并症和医疗服务的使用

• 批准号: 6052975
• 负责人: Carla A. Green
• 金额: $ 15.77万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-04-01 至 2002-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6052975
• 关键词: alcoholism /alcohol abuse; behavioral /social science research tag; clinical research; comorbidity; depression; gender difference; health care cost /financing; health care model; health care service utilization; health services research tag; human population study; human subject; mathematical model; model design /development; substance abuse epidemiology

APPLICANT'S ABSTRACT: Health care plans and providers are increasingly aware that they must identify, treat, and manage people who have alcohol problems and comorbid conditions such as depression and chronic illnesses. However, to identify such patients and address their problems appropriately, we need to understand how these comorbid conditions interact, and how patient characteristics affect such conditions and their outcomes. Researchers have been working to understand the factors that influence alcohol consumption, and to learn how that consumption affects morbidity, mortality, and use of health services. To date, our understanding of these relationships remains limited because the processes that affect alcohol use and utilization of health services are complex. To advance our knowledge, models must now include a complex mix of mental and physical comorbidities, functional status and individual characteristics. One of the most important of the individual-level factors affecting alcohol consumption and health service use is gender: It affects patterns of alcohol consumption, amounts and types of medical care used, and comorbid psychiatric and health conditions that underlie both alcohol and service use. In this exploratory/developmental grant, we will use existing data sets to address four main questions: (1) How do demographic factors, depression, health and functional status, and chronic illness jointly influence alcohol consumptions (2) How do demographic factors, alcohol consumption, depression, health and functional status, and chronic illness influence total cost of health services? (3) Do gender-specific models corresponding to Questions 1 and 2 provide superior explanations when compared to combined-gender models? (4) Do structural equation models enhance our understanding of these complex phenomena when compared to two-part regression models? Using an existing data set of 7844 randomly sampled HMO members age 25 and older, we will construct comprehensive regression and structural equation models of the processes leading to alcohol consumption, and then use the same modeling strategies to study how alcohol consumption affects health services use and costs. We will compare gender-specific models with combined-gender models to determine if the underlying processes differ between men and women, and evaluate the knowledge gained from the two-part regression and structural equation models to assess their relative contribution to our overall understanding of these outcomes.

申请人摘要：医疗保健计划和提供者越来越意识到 他们必须识别、治疗和管理有酒精问题的人 以及抑郁症和慢性病等共病。但要 识别这些患者并适当地解决他们的问题，我们需要 了解这些并发症如何相互作用，以及患者如何 特征影响这些条件及其结果。研究人员 一直在努力了解影响酒精消费的因素， 了解消费如何影响发病率、死亡率和健康使用 服务迄今为止，我们对这些关系的了解仍然有限 因为影响酒精使用和健康利用的过程 服务是复杂的。为了增进我们的知识，模型现在必须包括一个 复杂的精神和身体共病、功能状态和 个性特征其中最重要的个人层面 影响酒精消费和卫生服务使用的因素是性别：它 影响酒精消费模式、医疗护理的数量和类型 使用过的，以及共同的精神和健康状况， 酒精和服务使用。在这个探索性/发展性赠款中，我们将使用 现有的数据集，以解决四个主要问题：（1）如何人口 因素，抑郁症，健康和功能状态，以及慢性疾病联合 影响酒精消费（2）人口因素，酒精 消费、抑郁、健康和功能状态以及慢性疾病 影响卫生服务总成本？(3)有性别区分的模型 与问题1和2相对应的问题提供了上级的解释， 到男女混合模特(4)结构方程模型是否增强了我们的 与两部分回归相比， 模特？使用现有的7844名随机抽样的25岁健康维护组织成员的数据集， 在此基础上，建立综合回归方程和结构方程， 模型的过程导致酒精消费，然后使用相同的 研究酒精消费如何影响卫生服务的建模策略 使用和成本。我们将比较性别特异性模型与性别组合模型 确定男女之间潜在过程是否不同的模型， 并评估从两部分回归和结构分析中获得的知识 方程模型来评估它们对我们整体 了解这些结果。