National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, 00161 Rome, Italy.
Primary Healthcare Unit, Health District 9, Local Health Unit Roma 2, 00159 Rome, Italy.
Int J Environ Res Public Health. 2022 Aug 19;19(16):10340. doi: 10.3390/ijerph191610340.
(1) Age-friendly health systems ensure access to quality healthcare services to all people, especially older adults. (2) We used data on elderly population collected from 2016 to 2019 by the Italian ongoing surveillance system PASSI d'Argento to analyze the prevalence and associations between accessing health services and modifiable risk factors included in the 25 × 25 strategy for the burden of noncommunicable diseases with health outcomes. (3) Chronic diseases and hospitalization as descriptors of health status showed that the elderly perceived as having poor access to care and prevention incurred a higher risk of hospitalization. The association between difficulties in accessing health services and hospitalization was always the highest in terms of the adjusted prevalence ratio (aPR), regardless of the other behavioral risk factors considered, controlling each model with sociodemographic conditions. Elderly hospitalized at least once for two days or more in the last 12 months had greater risk to have problems in accessing health services, whereas the model included health conditions such as obesity (aPR = 1.95 95% CI 1.75-2.17), smoking (aPR = 1.95 95% CI 1.76-2.16), alcohol use (aPR = 1.93 95% CI 1.73-2.14), hypertension (aPR = 1.92 95% CI 1.73-2.13) and diabetes (aPR = 1.91 95% CI 1.73-2.12). (4) Health policies should encompass socio-economic and living environment barriers which prevent access to care among older adults.
(1) 老年友好型卫生系统确保所有人,尤其是老年人都能获得高质量的医疗保健服务。(2) 我们使用了意大利正在进行的 PASSI d'Argento 监测系统在 2016 年至 2019 年期间收集的老年人口数据,分析了在 25×25 战略中包含的可改变的健康服务利用和风险因素之间的相关性非传染性疾病负担与健康结果。(3) 慢性疾病和住院治疗作为健康状况的指标表明,老年人认为自己获得医疗和预防服务的机会较差,住院的风险更高。在调整后的患病率比(aPR)方面,无论考虑其他行为风险因素如何,健康服务获取困难与住院之间的关联始终最高,控制每个模型中的社会人口状况。在过去 12 个月中至少住院两次或以上的老年人,在获得健康服务方面遇到问题的风险更大,而包括肥胖(aPR = 1.95 95%CI 1.75-2.17)、吸烟(aPR = 1.95 95%CI 1.76-2.16)、饮酒(aPR = 1.93 95%CI 1.73-2.14)、高血压(aPR = 1.92 95%CI 1.73-2.13)和糖尿病(aPR = 1.91 95%CI 1.73-2.12)等健康状况的模型。(4) 卫生政策应包括社会经济和生活环境障碍,以防止老年人获得医疗服务。