Marsh P, Carlisle R, Avery A J
Division of General Practice, University of Nottingham, University Hospital.
Br J Gen Pract. 2000 Aug;50(457):630-4.
The best way for practices to determine the health status of patients living in areas with different socioeconomic characteristics is unclear.
To see how much SF-36 health status varies between electoral wards, how much of this variation can be explained by census-derived Jarman and Townsend scores, and compare the performance of census scores with direct socioeconomic information.
A postal questionnaire survey of 3000 randomly selected 18 to 75-year-olds residing in 15 electoral wards and registered with two urban practices.
The response rate was 73%. Only two of the eight SF-36 domains were significantly associated with Jarman scores, whereas seven domains were associated with the Townsend score. Of the four socioeconomic variables derived directly from the survey, unemployment showed the weakest association, housing tenure was associated with seven domains, and car ownership and low income were associated with all eight. Income explained between 47% to 71% of the variation across the eight domains.
The most accurate predictions about health status were made from direct socioeconomic information. Nonetheless, the association between Townsend score and health status was strong enough to be of practical importance. This study cautions against assuming the Jarman score of a population has a clear relationship with its health status.
目前尚不清楚医疗机构确定生活在不同社会经济特征地区患者健康状况的最佳方式。
了解选举选区之间SF-36健康状况的差异程度，以及人口普查得出的贾曼和汤森得分能在多大程度上解释这种差异，并将人口普查得分的表现与直接的社会经济信息进行比较。
对居住在15个选举选区、在两家城市医疗机构登记的3000名18至75岁的随机选择的人群进行邮寄问卷调查。
回复率为73%。SF-36的八个领域中只有两个与贾曼得分显著相关，而七个领域与汤森得分相关。在直接从调查中得出的四个社会经济变量中，失业率的关联性最弱，住房保有形式与七个领域相关，汽车拥有情况和低收入与所有八个领域相关。收入解释了八个领域中47%至71%的差异。
对健康状况的最准确预测来自直接的社会经济信息。尽管如此，汤森得分与健康状况之间的关联足够强，具有实际重要性。本研究提醒不要假定某一人群的贾曼得分与其健康状况有明确关系。
