Access and unmet needs to multiple sclerosis care in a cohort of Argentinean patients

被引：25

作者：

Carnero Contentti, Edgar ^{[1
]}

Pablo Pettinicchi, Juan ^{[1
]}

Lopez, Pablo A. ^{[1
]}

Alonso, Ricardo ^{[2
]}

Garcea, Orlando ^{[2
]}

Eugenia Balbuena, Maria ^{[3
]}

Bortoluzzi, Christian ^{[4
]}

Silva, Emanuel ^{[4
]}

Cabrera, Mariela ^{[5
]}

Celeste Curbelo, Maria ^{[6
]}

Pablo Hryb, Javier ^{[7
]}

Luis Di Pace, Jose ^{[7
]}

Perassolo, Monica ^{[7
]}

Ianardi, Sebastian ^{[8
]}

Mainella, Carolina ^{[9
]}

Mellinger, Surai ^{[10
]}

Migliacci, Leonel ^{[11
]}

Pagani Cassara, Fatima ^{[12
]}

Sinay, Vladimiro ^{[12
]}

Carra, Adriana ^{[12
]}

Questa Laudani, Mathias ^{[13
]}

Ruiz Romagnolin, Emiliano ^{[14
]}

Liwacki, Susana ^{[14
]}

Piedrabuena, Raul ^{[14
]}

Tizio, Santiago ^{[15
]}

Tkachuk, Veronica ^{[3
]}

机构：

[1] Hosp Aleman, Dept Neurosci, Neuroimmunol Unit, Av Pueyrredon 1640,C1118AAT, Av Pueyrred6n, Argentina

[2] Hosp Ramos Mejia, Neurol Dept, Clin Esclerosis Multiple, Buenos Aires, DF, Argentina

[3] Hosp Clin Jose San Martin, Serv Neurol, Sect Neuroinmunol & Enfermedades Desmielinizantes, Buenos Aires, DF, Argentina

[4] Hosp Madariaga Posadas, Neurol Dept, Misiones, Argentina

[5] Hosp Mil Cent Dr Cosme Argerich, Neurol Dept, Buenos Aires, DF, Argentina

[6] Hosp Britanico Buenos Aires, MS Sect, Buenos Aires, DF, Argentina

[7] Hosp Carlos G Durand, Secc Neurol, Buenos Aires, DF, Argentina

[8] Hosp Lagomaggiore, Neurol Dept, Mendoza, Argentina

[9] Fdn Rosarina Neurorehabil, Rosario, Santa Fe, Argentina

[10] Hosp San Bernardo, Neurol Dept, Salta, Argentina

[11] Clin Pueyrredon Mar del Plata, Mar Del Plata, Buenos Aires, Argentina

[12] Fdn Favaloro INECO, Neurol Dept, Buenos Aires, DF, Argentina

[13] Ctr Integral Enfermedades Neurol & Neuroquirurg, Santiago Del Estero, Argentina

[14] Hosp Cordoba, Clin Univ Reina Fabiola, Cordoba, Spain

[15] Hosp Italiano & Espanol La Plata, Neurol Dept, La Plata, Buenos Aires, Argentina

来源：

MULTIPLE SCLEROSIS AND RELATED DISORDERS | 2019年 / 33卷

关键词：

Access to MS care; Multiple sclerosis; Latin America; Burden of MS; Healthcare; QUALITY-OF-LIFE; BUENOS-AIRES; EMPLOYMENT STATUS; HEALTH-INSURANCE; PREVALENCE; DISABILITY; BURDEN; COSTS; MS; PERSPECTIVE;

D O I：

10.1016/j.msard.2019.05.024

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background: Multiple sclerosis (MS) has a low prevalence in Argentina. However, MS has a high burden of disease, which implies frequent neurological visits, magnetic resonance images (MRI) use and chronic MS medication during follow-up, with a high impact on the healthcare system. Therefore, MS care is essential to optimize disease management and improve patients' outcome. We aimed to evaluate the access and barriers to MS care and identified differences in treatment and management of MS patients over a period of 12 months in an Argentinean cohort. Methods: A cross-sectional study based on a self-administered survey was carried out from August to December 2017 in 13 provinces from Argentina. MS patients (n = 219) were divided into three groups as follows: prepaid health insurance (PHI), social health insurance (SHI) and state-run health insurance (SRHI, Public Health Ministry) and they were assessed in order to detect differences in employment, access and barriers to MS care (neurological visit, MRI use and MS medication). Results: A total of 185 (84.5%) MS patients were employed (full-time: 59%), 34 (15.5%) were currently unemployed and 15 (6.8%) retired by MS. In addition, 132 had SHI, 45 PHI and 40 SRHI. No statistical differences were found in disease severity, frequency of neurological visit, waiting time for neurological visit as well as frequency and waiting time for MRI use. MS patients with SRHI experienced a longer waiting time (first prescription and during follow-up) and inappropriate delivery of MS medication during follow-up compared to MS patients with PHI and SHI. A total of 8/45 (17.7%) in PHI, 17/40 (42.5%) in SRHI and 25/132 (18.9%) in SHI did not receive the MS medication as properly as prescribed for their neurologists. PHI was independently associated with appropriate delivery of MS medication (OR = 0.81, p = 0.01). Conclusion: This study showed that MS patients had access barriers to receive MS medication properly, especially those with SRHI (public sector).

引用

页码：88 / 93

页数：6

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