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    Younger stroke survivors have reduced access to physician care and medications: National Health Interview Survey from years 1998 to 2002

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    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 Sciences
    Document Type
    Journal Article
    Publication Date
    2006-11-15
    Keywords
    Confidence Intervals
    Female
    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
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    Link to Full Text
    http://dx.doi.org/10.1001/archneur.64.1.noc60002
    Abstract
    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 site
    DOI
    10.1001/archneur.64.1.noc60002
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47291
    PubMed ID
    17101819
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1001/archneur.64.1.noc60002
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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