医疗保健利用的个体及社区决定因素。对卫生政策和资源分配的启示。
Individual and neighbourhood determinants of health care utilization. Implications for health policy and resource allocation.
作者信息
Yip Alexandra M, Kephart George, Veugelers Paul J
机构信息
Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5849 University Avenue, Halifax, NS B3H 4H7, Canada.
出版信息
Can J Public Health. 2002 Jul-Aug;93(4):303-7. doi: 10.1007/BF03405022.
OBJECTIVES
To investigate the importance of both individual and neighbourhood socioeconomic characteristics for health care utilization.
METHODS
Various linkage procedures generated a longitudinal dataset with information on 2,116 Nova Scotians, their residential neighbourhoods, 8 years of health care utilization and vital status. Unilevel and multilevel regression analyses were employed to examine the effects of both individual and neighbourhood characteristics on health care use.
RESULTS
Individual income and education determined physician and hospital use. Also, neighbourhood characteristics, specifically average income and percentage of single mother families, were found to determine health care use. When considering individual and neighbourhood characteristics simultaneously, individual income and education determined physician and hospital use independently, while neighbourhood income determined physician use independently.
CONCLUSIONS
Both individual and neighbourhood socioeconomic characteristics determine health care use. Acknowledging this allows better targeting of health policy and planning, and enables more accurate needs-based resource allocation.
目的
探讨个体及邻里社会经济特征对医疗保健利用的重要性。
方法
通过各种链接程序生成了一个纵向数据集，其中包含2116名新斯科舍人的信息、他们居住的社区、8年的医疗保健利用情况和生命状况。采用单水平和多水平回归分析来检验个体和邻里特征对医疗保健使用的影响。
结果
个人收入和教育程度决定了看医生和住院的情况。此外，邻里特征，特别是平均收入和单亲家庭百分比，也被发现会影响医疗保健的使用。当同时考虑个体和邻里特征时，个人收入和教育程度独立地决定了看医生和住院的情况，而邻里收入则独立地决定了看医生的情况。
结论
个体和邻里社会经济特征都决定了医疗保健的使用。认识到这一点有助于更好地制定卫生政策和规划目标，并实现更准确的基于需求的资源分配。
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