哮喘联盟

   摘要
   目的：对来自酒精或毒品上瘾（AODD）家庭的儿童（CFMs）和来自哮喘或糖尿病家庭的儿童，进行以下比较：健康问题、预防保健护理的利用以及医疗费用。
   方法：纳入2002－2005年间AODD家庭儿童和哮喘或糖尿病家庭儿童，并在父母被诊断后对儿童进行长达7年的随访。采用逻辑回归来分析AODD的CFMs是否比哮喘或糖尿病家庭儿童更容易发生健康问题或更需要预防保健护理。采用多变量模型比较儿童卫生医疗服务使用情况。
   结果：随访5年，AODD的CFMs比哮喘或糖尿病家庭儿童更易患抑郁症和AODD，比哮喘的CFMs较少得哮喘、中耳炎和肺炎。AODD的CFMs比哮喘家庭儿童更少参加每年的健康儿童咨询。AODD的CFMs与哮喘家庭儿童的年平均总医疗费用无显著差异，但高于糖尿病家庭儿童（每年高$159，可信区间，$56-$253）。AODD的CFMs比哮喘或糖尿病家庭儿童急诊次数、门诊毒品&酒精康复计划参与次数、门诊精神科就诊次数均更高，但其初级医疗保健费用却低于哮喘或糖尿病家庭儿童。
   结论：相比哮喘或糖尿病家庭儿童，酒精或毒品上瘾家庭儿童的健康状况模式独特，两者接受的医疗保健服务类型不同。但是，两者的总医疗费用及医疗保健服务的使用情况相似，或者说酒精或毒品上瘾家庭儿童略高。本研究首次对这两种家庭儿童的医疗保健状况进行分析，结果提示医疗服务人员应该致力于降低父母对酒精或毒品的依赖，这将是医疗改革进程中一个重要问题。
 

（苏楠 审校）
 2014 May;35(4):282-91. doi: 10.1097/DBP.0000000000000049.

 

Comparison of health care needs of child family members of adults with alcohol or drug dependence versus adults with asthma or diabetes.
 

Ray GT1, Mertens JR, Weisner C.
 

ABSTRACT
OBJECTIVE: To compare the health problems, preventive care utilization, and medical costs of child family members (CFMs) of adults diagnosed with alcohol or drug dependence (AODD) to CFMs of adults diagnosed with diabetes or asthma.
METHODS: Child family members of adults diagnosed with AODD between 2002 and 2005 and CFMs of matched adults diagnosed with diabetes or asthma were followed up to 7 years after diagnosis of the index adult. Logistic regression was used to determine whether the CFMs of AODD adults were more likely to be diagnosed with medical conditions, or get preventive care, than the CFMs of adults with asthma or diabetes. Children's health services use was compared using multivariate models.
RESULTS: In Year 5 after index date, CFMs of adults with AODD were more likely to be diagnosed with depression and AODD than CFMs of adults with asthma or diabetes and were less likely to be diagnosed with asthma, otitis media, and pneumonia than CFMs of adults with asthma. CFMs of AODD adults were less likely than CFMs of adult asthmatic patients to have annual well-child visits. CFMs of AODD adults had similar mean annual total health care costs to CFMs of adults with asthma but higher total costs ($159/yr higher, confidence interval, $56-$253) than CFMs of adult diabetic patients. CFMs of adults with AODD had higher emergency department, higher outpatient alcohol and drug program, higher outpatient psychiatry, and lower primary care costs than CFMs of either adult asthmatic patients or diabetic patients.
CONCLUSION: Children in families with an alcohol- or drug-dependent adult have unique patterns of health conditions, and differences in the types of health services used, compared to children in families with an adult asthmatic or diabetic family member. However, overall cost and utilization for health care services is similar or only somewhat higher. This is the first study of its kind, and the results have implications for the reduction of parental alcohol or drug dependence stigma by health care providers, clearly an important issue in this era of health reform.
 

2014 May;35(4):282-91. doi: 10.1097/DBP.0000000000000049.