Beale Norman R, Taylor Gordon J, Straker-Cook Dawn M K
Northlands R & D General Practice, Calne, United Kingdom.
BMC Public Health. 2002 Sep 3;2:17. doi: 10.1186/1471-2458-2-17.
All current UK indices of socio-economic status have inherent problems, especially those used to govern resource allocation to the health sphere. The search for improved markers continues: this study proposes and tests the possibility that Council Tax Valuation Band (CTVB) might match requirements.
To determine if there is an association between CTVB of final residence and mortality risk using the death registers of a UK general practice.
Standardised death rates and odds ratios (ORs) for groups defined by CTVB of dwelling (A - H) were calculated using one in four denominator samples from the practice lists. Analyses were repeated three times - between number of deaths and CTVB of residence of deceased 1992 - 1994 inclusive, 1995 - 1997 inc., 1998 - 2000 inc. In 856 deaths there were consistent and significant differences in death rates between CTVBs: above average for bands A and B residents; below average for other band residents. There were significantly higher ORs for A, B residents who were female and who died prematurely (before average group life expectancy).
CTVB of final residence appears to be a proxy marker of mortality risk and could be a valuable indicator of health needs resource at household level. It is worthy of further exploration.
英国目前所有的社会经济地位指标都存在内在问题,尤其是那些用于指导卫生领域资源分配的指标。对改进指标的探索仍在继续:本研究提出并检验了市政税估值等级(CTVB)可能符合要求的可能性。
利用英国一家普通诊所的死亡登记册,确定最终居住地的CTVB与死亡风险之间是否存在关联。
使用该诊所名单中四分之一的分母样本,计算按居住的CTVB(A - H级)定义的组的标准化死亡率和比值比(OR)。分析重复进行了三次——分别在1992年至1994年(含)、1995年至1997年(含)、1998年至2000年(含)期间死亡人数与死者居住的CTVB之间进行分析。在856例死亡病例中,不同CTVB之间的死亡率存在一致且显著的差异:A组和B组居民的死亡率高于平均水平;其他组居民的死亡率低于平均水平。A组和B组中女性以及过早死亡(在平均群体预期寿命之前)的居民的OR显著更高。
最终居住地的CTVB似乎是死亡风险的一个替代指标,并且可能是家庭层面卫生需求资源的一个有价值的指标。值得进一步探索。