文摘

目的:描述未滿足的醫療需求和中風患者和識別社會人口和健康特征與這些未滿足的需求調查相關的適當性衛生保健。設置:樣本的患者參與了一項多中心研究(醫院)23日在荷蘭的醫療質量。病人:Non-institutionalised病人因中風住院。患者接受采訪的六個月(n = 382)和卒中後五年(n = 224)。設計:卒中後6個月的數據收集:(a)社會人口特征的年齡、性別、生活安排,教育水平,和區域城市化水平;(b)健康特征在認知功能方麵,殘疾,情感壓抑,和一般衛生觀念;(c)專業護理的利用率;和(d)未滿足的醫療需求,被病人。醫療數據利用率和未滿足的需求也收集了卒中後五年。數據收集從1991年6月到1996年12月。 RESULTS: The percentage of unmet care demands was highest at six months after stroke (n = 120, 31%). Multiple logistic regression analyses showed that disabled patients were more likely to be unmet demanders for therapy, (I)ADL care and aids (range odds ratio (OR) = 3.5 to 7.9) than to be no demanders, whereas emotionally distressed patients were more likely to be unmet demanders for psychosocial support (OR = 3.8). When comparing unmet demanders with care users only for (instrumental) activities of daily living (I)ADL care differences were found: men (OR = 3.8), disabled patients (OR = 3.0), and emotionally distressed patients (OR = 6.5) were more likely to be users. CONCLUSIONS: Patients who perceived an unmet care demand do appear genuinely to have an unmet care need as supported by assessment of their health status: (a) types of unmet care demands correspond with types of health problems and (b) unmet demanders were in general unhealthier than no demanders and more comparable with care users for health characteristics. IMPLICATIONS: To improve an equitable distribution of healthcare services, guidelines for indicating and allocating health care have to be developed and should be based on scientific evidence and consensus meetings including professionals' and patients' perspectives.