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首页> 外文期刊>Journal of women’s health >Health Care Disparities Among US Women of Reproductive Age by Level of Psychological Distress
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Health Care Disparities Among US Women of Reproductive Age by Level of Psychological Distress

机译：通过心理困扰水平的美国生殖年龄的医疗保健差异

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Purpose: Reproductive-age women have a high rate of contact with the health care system for reproductive health care. Yet, beyond pregnancy, little is known about psychological distress and unmet health care needs among these women. We examined reasons for delayed medical care and types of foregone care by level of psychological distress. Methods: We used a nationally representative sample of U.S. women aged 18-49, from the 2015-2016 National Health Interview Survey. Using the K6 screening tool for nonspecific psychological distress, we examined differences in reasons for delayed care and types of care foregone due to cost by level of psychological distress (none, moderate psychological distress [MPD], and severe psychological distress [SPD]). Results: Overall, 20% of U.S. women aged 18-49 had MPD (16%) or SPD (4%), equating to nearly 13 million women of reproductive age living with psychological distress. Women with SPD or MPD are more likely to have delayed and foregone care. Notably, women with SPD have higher odds of needing but not receiving mental health care (adjusted odds ratios [AOR] = 12.4, 95% confidence interval [CI] 8.4-18.4), specialist care (AOR = 3.6, 95% CI 2.6-5.1), and follow-up care (AOR = 3.5, 95% CI 2.4-5.1) due to cost than women with no psychological distress. Cost is the greatest barrier to timely medical care for women with MPD and SPD. Conclusions: Women of reproductive age with psychological distress face considerable structural and cost-related barriers to accessing health care, which may be exacerbated by their psychological state. Despite recent policy advances such as the Affordable Care Act, additional efforts by policymakers and providers are crucial to address the needs of this population.
机译：目的：生殖年龄妇女与生殖保健保健系统具有很高的接触率。然而，除怀孕之外，这些女性之间的心理困扰和未满足的医疗保健需求很少。通过心理困扰的水平，我们检查了延迟医疗保健和食品类型的原因。方法：从2015 - 2016年国家卫生面试调查中使用了18-49岁的美国妇女的全国代表性样本。使用K6筛选工具进行非特异性心理困扰，我们认为由于心理困扰水平的成本（无，中度心理窘迫[MPD]和严重的心理窘迫[SPD]），我们检查了延迟护理和护理类型的差异。结果：总体而言，18-49岁的美国妇女的20％具有MPD（16％）或SPD（4％），等同于近1300万妇女，生殖年龄与心理困扰生活。 SPD或MPD的妇女更有可能延迟并放弃护理。值得注意的是，具有SPD的妇女需要较高的需要但未接受心理保健（调整的差距[AOR] = 12.4,95％置信区间[CI] 8.4-18.4），专业护理（AOR = 3.6,95％CI 2.6- 5.1），随访护理（AOR = 3.5,95％CI 2.4-5.1），由于没有心理困扰的女性。成本是最伟大的障碍，用于及时医疗MPD和SPD的女性。结论：生殖年龄的妇女，心理困扰面临相当大的结构性和与成本相关的障碍，以获得医疗保健，这可能会因其心理状态而加剧。尽管最近的政策取得了经济实惠的护理法案，但政策制定者和提供商的额外努力对于满足该人群的需求至关重要。

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