Your browser doesn't support javascript.
loading
Assessing how frailty and healthcare delays mediate the association between sexual and gender minority status and healthcare utilization in the All of Us Research Program.
Wong, Chelsea N; Smith, Louisa H; Cavanaugh, Robert; Kim, Dae H; Streed, Carl G; Kapadia, Farzana; Olivieri-Mui, Brianne.
Afiliación
  • Wong CN; Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02445, United States.
  • Smith LH; Department of Medicine, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131, United States.
  • Cavanaugh R; Roux Institute, Northeastern University, Portland, ME 04101, United States.
  • Kim DH; Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, United States.
  • Streed CG; Roux Institute, Northeastern University, Portland, ME 04101, United States.
  • Kapadia F; Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02445, United States.
  • Olivieri-Mui B; Department of Medicine, Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131, United States.
J Am Med Inform Assoc ; 2024 Jul 30.
Article en En | MEDLINE | ID: mdl-39078278
ABSTRACT

OBJECTIVES:

To understand how frailty and healthcare delays differentially mediate the association between sexual and gender minority older adults (OSGM) status and healthcare utilization. MATERIALS AND

METHODS:

Data from the All of Us Research Program participants ≥50 years old were analyzed using marginal structural modelling to assess if frailty or healthcare delays mediated OSGM status and healthcare utilization. OSGM status, healthcare delays, and frailty were assessed using survey data. Electronic health record (EHR) data was used to measure the number of medical visits or mental health (MH) visit days, following 12 months from the calculated All of Us Frailty Index. Analyses adjusted for age, race and ethnicity, income, HIV, marital status ± general MH (only MH analyses).

RESULTS:

Compared to non-OSGM, OSGM adults have higher rates of medical visits (adjusted rate ratio [aRR] 1.14; 95% CI 1.03, 1.24) and MH visits (aRR 1.85; 95% CI 1.07, 2.91). Frailty mediated the association between OSGM status medical visits (Controlled direct effect [Rcde] aRR 1.03, 95% CI [0.87, 1.22]), but not MH visits (Rcde aRR 0.37 [95% CI 0.06, 1.47]). Delays mediated the association between OSGM status and MH visit days (Rcde aRR 2.27, 95% CI [1.15, 3.76]), but not medical visits (Rcde aRR 1.06 [95% CI 0.97, 1.17]).

DISCUSSION:

Frailty represents a need for medical care among OSGM adults, highlighting the importance of addressing it to improve health and healthcare utilization disparities. In contrast, healthcare delays are a barrier to MH care, underscoring the necessity of targeted strategies to ensure timely MH care for OSGM adults.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Med Inform Assoc Asunto de la revista: INFORMATICA MEDICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Med Inform Assoc Asunto de la revista: INFORMATICA MEDICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido