Mott J A
Health Policy Center, University of Illinois at Chicago, USA.
Inj Prev. 1999 Sep;5(3):189-93. doi: 10.1136/ip.5.3.189.
This study examined the independent contributions of demographic, behavioral, and environmental antecedents of pediatric medically attended injuries that occurred in the home.
Two household and thirty six American children aged 4-12 in 1988 were drawn from the National Longitudinal Survey of Youth.
Multiple logistic regression was used to examine whether having a medically attended injury that occurred in the home in 1990 was related to environmental, behavioral, and demographic indicators measured in 1988. To account for individual differences in access to care, results were stratified within samples of children that had, and had not, demonstrated a prior ability to access the medical care system for injury treatment.
Among children who did not access the medical care system for injury treatment in 1988, measures of home environmental risk factors did not distinguish those injured at home from those not injured at home in 1990. However, among children who did access the medical care system for injury treatment in 1988, indicators of "dark" (relative risk 4.68, p = 0.019) and "cluttered" (relative risk 4.31, p = 0.038) home environments became significantly and independently associated with home injuries in 1990.
If not accounted for in data collection or analyses, individual differences in non-financial barriers to medical care may read to an underestimation of the influences of important home environmental risk factors for medically attended injuries.
本研究探讨了家庭中儿童需要就医的伤害事件的人口统计学、行为学和环境学相关因素的独立作用。
1988年,从全国青年纵向调查中选取了两个家庭的36名4至12岁的美国儿童。
采用多因素logistic回归分析,研究1990年家庭中发生的需要就医的伤害事件是否与1988年测量的环境、行为和人口统计学指标相关。为了考虑获得医疗服务的个体差异,结果在已证明和未证明有能力获得医疗系统进行伤害治疗的儿童样本中进行分层分析。
在1988年未获得医疗系统进行伤害治疗的儿童中,家庭环境危险因素的测量未能区分1990年在家中受伤和未受伤的儿童。然而,在1988年获得医疗系统进行伤害治疗的儿童中,“昏暗”(相对危险度4.68,p = 0.019)和“杂乱”(相对危险度4.31,p = 0.038)的家庭环境指标与1990年的家庭伤害显著且独立相关。
如果在数据收集或分析中未考虑到,医疗服务的非财务障碍方面的个体差异可能会导致低估重要的家庭环境危险因素对需要就医的伤害事件的影响。