Division of General Medicine and Geriatrics, Emory University School of Medicine, 49 Jesse Hill Jr Drive #438, Atlanta, GA, 30303, USA.
Georgia State University, Atlanta, GA, USA.
J Racial Ethn Health Disparities. 2019 Dec;6(6):1228-1232. doi: 10.1007/s40615-019-00624-6. Epub 2019 Aug 13.
While driving is an important instrumental activity of daily living (ADL), older adults belonging to low-income racial minorities make up a large proportion of never-drivers who utilize alternative modes of transportation (Babulal et al., Geriatrics 3, 2018; Choi and Mezuk, J Appl Gerontol 32:902-912, 2013). Our study is a comparative analysis of comorbid health conditions among older drivers and nondrivers receiving care at a safety net hospital in Atlanta in order to assess utilization of healthcare resources and chronic disease burden among the two groups.
This is a retrospective cohort study of 690 patients age 65 or older who received care at the Emma Darnell Geriatric Center at Grady Hospital during 2/1/2016-2/1/2017. Self-reported driving status was analyzed and compared for all variables including demographics, insurance information, ADL scores, use of assistive device, sensory impairment, number of Geriatric Clinic visits in a year, and associated visit diagnoses.
Twenty-three percent of total 690 patients reported being drivers. Over 94% patients were African Americans and over 67% were women in both groups. Drivers were more functionally independent and were less likely to have cognitive impairment compared with nondrivers. Mean number of visits to Geriatric Primary Care Clinic in a year was low in both groups, and enrollment in a Medicare advantage plan did not affect the association.
Approximately 77% of older adults getting care at a safety net hospital in Atlanta reported not driving a motor vehicle. Utilization of primary healthcare resources was low in both groups and was not affected by enrollment in a Medicare advantage plan.
虽然驾驶是日常生活中重要的工具性活动(ADL),但属于低收入少数族裔的老年人中,有很大一部分是从不驾驶的人,他们使用替代交通方式(Babulal 等人,老年学 3,2018;Choi 和 Mezuk,J Appl Gerontol 32:902-912,2013)。我们的研究是对亚特兰大一家医疗保障网医院接受护理的老年驾驶员和非驾驶员的合并健康状况进行的比较分析,以评估这两组人群的医疗资源利用情况和慢性病负担。
这是一项回顾性队列研究,纳入了 2016 年 2 月 1 日至 2017 年 2 月 1 日期间在艾玛·达内尔老年医学中心接受治疗的 690 名 65 岁或以上的患者。分析并比较了两组人群的自报驾驶状况和所有变量,包括人口统计学信息、保险信息、ADL 评分、辅助设备使用、感觉障碍、一年内在老年诊所就诊次数以及相关就诊诊断。
690 名患者中,23%的患者报告自己会开车。两组患者中,超过 94%为非裔美国人,超过 67%为女性。与非驾驶员相比,驾驶员的功能独立性更高,认知障碍的可能性更小。两组患者每年到老年初级保健诊所就诊的次数都较少,而且参加医疗保险优势计划并不会影响这一关联。
亚特兰大一家医疗保障网医院的老年患者中,约有 77%的人不驾驶机动车辆。两组患者的初级医疗资源利用率都较低,且不受参加医疗保险优势计划的影响。