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dc.contributor.authorLevine, Deborah A.
dc.contributor.authorKiefe, Catarina I.
dc.contributor.authorHouston, Thomas K.
dc.contributor.authorAllison, Jeroan J.
dc.contributor.authorMcCarthy, Ellen P.
dc.contributor.authorAyanian, John Z.
dc.date2022-08-11T08:10:40.000
dc.date.accessioned2022-08-23T17:15:59Z
dc.date.available2022-08-23T17:15:59Z
dc.date.issued2006-11-15
dc.date.submitted2010-04-27
dc.identifier.citationArch Neurol. 2007 Jan;64(1):37-42. Epub 2006 Nov 13. <a href="http://dx.doi.org/10.1001/archneur.64.1.noc60002">Link to article on publisher's site</a>
dc.identifier.issn0003-9942 (Linking)
dc.identifier.doi10.1001/archneur.64.1.noc60002
dc.identifier.pmid17101819
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47291
dc.description.abstractBACKGROUND: 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.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=17101819&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1001/archneur.64.1.noc60002
dc.subjectConfidence Intervals
dc.subjectFemale
dc.subjectHealth Care Costs
dc.subject*Health Care Surveys
dc.subjectHealth Services Accessibility
dc.subjectHealth Services Needs and Demand
dc.subjectHumans
dc.subjectInsurance, Health
dc.subjectInterviews as Topic
dc.subjectMale
dc.subjectMedically Uninsured
dc.subjectMiddle Aged
dc.subjectOdds Ratio
dc.subjectPhysician-Patient Relations
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectStroke
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleYounger stroke survivors have reduced access to physician care and medications: National Health Interview Survey from years 1998 to 2002
dc.typeJournal Article
dc.source.journaltitleArchives of neurology
dc.source.volume64
dc.source.issue1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/43
dc.identifier.contextkey1287788
html.description.abstract<p>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.</p> <p>OBJECTIVE: To assess age-related differences in access to physician care and medications among stroke survivors (aged 45-64 years vs > or = 65 years).</p> <p>DESIGN: National Health Interview Survey from years 1998 to 2002.</p> <p>SETTING: A US population-based survey.</p> <p>PARTICIPANTS: Stroke survivors (n = 3681) aged 45 years and older among 159 985 survey respondents.</p> <p>MAIN OUTCOME MEASURES: General doctor visit, medical specialist visit, and inability to afford medications within the last 12 months.</p> <p>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.</p> <p>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.</p>
dc.identifier.submissionpathqhs_pp/43
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages37-42


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