Background Patients can have several illnesses concurrently, yet some of these diseases may be neglected if one problem consumes attention.
We conducted a population-based analysis in Ontario, Canada - where universal health insurance is provided - to determine whether unrelated disorders are less likely to be treated in patients with chronic diseases.
Methods We studied the 1,344,145 residents of Ontario in 1995 who were 65 or older and eligible to receive prescription medications free of charge as part of the Ontario Drug Benefit program.
Patients with diabetes mellitus were identified by prescriptions for insulin, pulmonary emphysema by prescriptions for ipratropium bromide, and psychotic syndromes by prescriptions for haloperidol.
For each chronic disease, we selected an unrelated treatment : estrogen-replacement therapy for patients with diabetes mellitus, lipid-lowering medications for those with pulmonary emphysema, and medical treatment of arthritis for those with psychotic syndromes.
Results The 30,669 patients with diabetes mellitus were less likely to receive estrogen-replacement therapy than the other subjects in the study (2.4 percent vs. 5.9 percent, P<0.001).
The disease was associated with a 60 percent reduction in the odds of estrogen treatment (odds ratio, 0.40 ; 95 percent confidence interval, 0.37 to 0.43). (...)
Mots-clés Pascal : Maladie, Chronique, Dépistage, Trouble fonctionnel, Vieillard, Homme, Prescription médicale, Relation médecin malade, Evaluation, Facteur efficacité, Canada, Amérique du Nord, Amérique, Politique sanitaire
Mots-clés Pascal anglais : Disease, Chronic, Medical screening, Dysfunction, Elderly, Human, Medical prescription, Physician patient relation, Evaluation, Effectiveness factor, Canada, North America, America, Health policy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0265830
Code Inist : 002B30A03B. Création : 11/09/1998.