Younger stroke survivors have reduced access to physician care and medications: National Health Interview Survey from years 1998 to 2002
Authors
Levine, Deborah A.Kiefe, Catarina I.
Houston, Thomas K.
Allison, Jeroan J.
McCarthy, Ellen P.
Ayanian, John Z.
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2006-11-15Keywords
Confidence IntervalsFemale
Health Care Costs
*Health Care Surveys
Health Services Accessibility
Health Services Needs and Demand
Humans
Insurance, Health
Interviews as Topic
Male
Medically Uninsured
Middle Aged
Odds Ratio
Physician-Patient Relations
Retrospective Studies
Risk Factors
Stroke
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: More than 5 million US stroke survivors require comprehensive care for risk factor modification and secondary prevention. Younger stroke survivors may have reduced access to physician care and medications because they are more frequently uninsured. OBJECTIVE: To assess age-related differences in access to physician care and medications among stroke survivors (aged 45-64 years vs > or = 65 years). DESIGN: National Health Interview Survey from years 1998 to 2002. SETTING: A US population-based survey. PARTICIPANTS: Stroke survivors (n = 3681) aged 45 years and older among 159 985 survey respondents. MAIN OUTCOME MEASURES: General doctor visit, medical specialist visit, and inability to afford medications within the last 12 months. RESULTS: Compared with older stroke survivors, younger stroke survivors more frequently reported no general doctor visit (10% vs 14%, respectively; P = .002), no general doctor or medical specialist visit (5% vs 8%, respectively; P = .003), and the inability to afford medications (6% vs 15%, respectively; P<.001). Younger age was independently associated with no general doctor visit (odds ratio, 1.40; 95% confidence interval, 1.04-1.88), no general doctor or medical specialist visit (odds ratio, 1.69; 95% confidence interval, 1.14-2.52), and the inability to afford medications (odds ratio, 2.94; 95% confidence interval, 2.19-3.94) after adjusting for sex, race, income, neurological disability, health status, and comorbidity. With further adjustment for health insurance, younger age remained independently associated with the inability to afford medications but not the lack of physician visits. CONCLUSIONS: Stroke survivors younger than 65 years reported worse access to physician care and medication affordability than older stroke survivors. Inadequate access among younger stroke survivors may lead to inadequate risk factor modification and recurrent cardiovascular events.Source
Arch Neurol. 2007 Jan;64(1):37-42. Epub 2006 Nov 13. Link to article on publisher's siteDOI
10.1001/archneur.64.1.noc60002Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47291PubMed ID
17101819Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1001/archneur.64.1.noc60002
Scopus Count
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