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贫困社区医院使用率增加的本质:来自加拿大一个市中心区的研究结果。

The nature of increased hospital use in poor neighbourhoods: findings from a Canadian inner city.

作者信息

Glazier R H, Badley E M, Gilbert J E, Rothman L

机构信息

Department of Family and Community Medicine, University of Toronto, Ontario.

出版信息

Can J Public Health. 2000 Jul-Aug;91(4):268-73. doi: 10.1007/BF03404286.

Abstract

The relationship between socioeconomic factors and hospital use is not well understood in the Canadian context. We used the 1991 Canada census and 1990-92 Ontario hospital discharge abstracts for residents of southeast Toronto to calculate crude and age-sex adjusted rates of hospital admission, bed days, and costs by quintile of low-income households. Population-based rates of admission to hospital, bed days and costs were all significantly related to census tract income (p < 0.01 for males and females). The number of admissions per person admitted was significantly associated with census tract income (p < 0.01 for males and females), but length of stay and resource intensity weight were not. Hospital costs were 50.0% higher for the poorest quintile of neighbourhoods than for the wealthiest and 35.8% higher than for the middle-income quintile. Poor urban neighbourhoods may require more resources than previously anticipated, related to higher hospital admission and readmission rates.

摘要

在加拿大的背景下,社会经济因素与医院利用之间的关系尚未得到充分理解。我们利用1991年加拿大人口普查数据以及1990 - 1992年安大略省针对多伦多东南部居民的医院出院摘要,按低收入家庭五分位数计算住院率、住院天数和费用的粗率及年龄 - 性别调整率。基于人群的住院率、住院天数和费用均与普查区收入显著相关(男性和女性的p值均<0.01)。每人的住院次数与普查区收入显著相关(男性和女性的p值均<0.01),但住院时长和资源强度权重并非如此。最贫困五分位数社区的医院费用比最富裕社区高50.0%,比中等收入五分位数社区高35.8%。贫困的城市社区可能需要比先前预期更多的资源,这与较高的住院率和再入院率有关。

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