Slack R, Ferguson B, Ryder S
York Health Economics Consortium, University of York, UK.
Health Serv Manage Res. 1997 Feb;10(1):24-31. doi: 10.1177/095148489701000104.
The objective of this paper is to investigate the relevance of access to hospital services in explaining utilization rates at a District Health Authority level in the UK. In order to test the hypothesis that access is important, it is necessary to develop a means of scoring access factors and then combining these scores with other more recognized influences on hospitalization rates e.g. deprivation measures. Acknowledging that hospitalization rates are not merely products of a population's socio-economic characteristics, the effect of accessibility to hospital services for the resident population is investigated through the derivation of an access score using both private and public transport from electoral ward of residence. Deprivation and accessibility to services were both found to be significant factors in determining hospitalization rates at electoral ward level. The chosen supply variable--number of GPs--was not found to be significant in any of the models developed using linear regression techniques. To conclude, it appears that access plays an important role in determining hospitalization rates within a given population. If high hospitalization rates are accepted as an indicator of effectively met demand then policy makers may have to consider increasing the accessibility of hospital services.
本文的目的是研究在英国地区卫生管理局层面，获得医院服务的机会与使用率之间的相关性。为了检验获得服务机会很重要这一假设，有必要开发一种对获得服务机会因素进行评分的方法，然后将这些分数与其他对住院率有更广泛认可影响的因素（如贫困程度衡量指标）相结合。认识到住院率不仅仅是人口社会经济特征的产物，通过使用来自居住选区的私人和公共交通方式得出一个获得服务机会分数，来研究居民获得医院服务的机会所产生的影响。研究发现，贫困程度和获得服务的机会都是决定选区层面住院率的重要因素。在使用线性回归技术建立的任何模型中，所选的供应变量——全科医生数量——都不具有显著性。总之，在特定人群中，获得服务的机会在决定住院率方面似乎起着重要作用。如果将高住院率视为有效满足需求的一个指标，那么政策制定者可能不得不考虑提高医院服务的可及性。
