目的:评估自我报告吞咽困难和治疗的患病率的社会人口统计学差异,并确定获得护理的障碍。
方法:横断面分析。
方法:国家医疗保健调查数据库。
方法:2012年国家健康访谈调查用于分析在过去12个月内报告吞咽问题的成年人。通过多变量逻辑回归确定社会人口统计学变量与吞咽困难患病率和治疗以及获得护理的关系。
结果:在美国2.35亿成年人中,9.4±30万(4.0%±0.1%)成年人(平均年龄52.1±0.6岁;60.2%的女性)报告了吞咽问题,只有19.2%±2.0%的人报告接受了吞咽问题的治疗或治疗。在控制社会人口因素的多变量模型中,女性性别,年龄较大,收入水平较低,公共保险状况和失业与报告吞咽困难的几率增加独立相关,同时也与接受治疗的几率降低有关。相反,黑色,西班牙裔和其他种族/少数民族不太可能报告吞咽问题,但是在那些报告吞咽困难的人中,非白种人更有可能接受治疗.导致延迟照顾妇女的障碍,低收入成年人和有公共或没有医疗保险的成年人包括费用,不能尽快预约,有限的办公时间,无法通过电话接通办公室,缺乏交通,办公室等待时间长。
结论:吞咽困难风险较高的社会人口统计学群体接受治疗的可能性较小。需要有针对性的干预措施来解决护理障碍。
方法:IV.
OBJECTIVE: To assess sociodemographic differences in the prevalence of self-reported dysphagia and treatment and to identify barriers in access to care.
METHODS: Cross-sectional analysis.
METHODS: National healthcare survey database.
METHODS: The 2012 National Health Interview Survey was used to analyze adults who reported a swallowing problem in the prior 12 months. Associations of sociodemographic variables with dysphagia prevalence and treatment as well as access to care were determined by multivariate logistic regression.
RESULTS: Among 235 million adults in the United States, 9.4 ± 0.3 million (4.0 % ± 0.1 %) adults (mean age 52.1 ± 0.6 years; 60.2 % female) reported swallowing problems, only 19.2 % ± 2.0 % of whom reported receiving treatment or therapy for their swallowing problem. In a multivariate model controlling for sociodemographic factors, female gender, older age, lower income level, public insurance status and unemployment were independently associated with increased odds of reporting dysphagia, while also associated with decreased odds of receiving treatment. Conversely, Black, Hispanic and other racial/ethnic minorities were less likely to report swallowing problems, but among those who did report dysphagia, non-white adults were more likely to receive treatment. Barriers leading to delayed care for women, low-income adults and adults with public or no health insurance included cost, not being able to get an appointment soon enough, limited office hours, inability to get through to an office by phone, lack of transportation, and long office wait times.
CONCLUSIONS: Sociodemographic groups at higher risk for dysphagia are less likely to receive treatment. Targeted interventions are needed to address barriers to care.
METHODS: IV.