Leino-Arjas P, Kaila-Kangas L, Keskimäki I, Notkola V, Mutanen P
Finnish Institute of Occupational Health, Helsinki, Finland.
Public Health. 2002 Sep;116(5):272-8. doi: 10.1038/sj.ph.1900868.
The object of the study was to describe socioeconomic and demographic determinants of inpatient hospital care for lumbar intervertebral disc disorders (LIDD) in Finland. Information from the 1996 Finnish Hospital Discharge Register was linked with the 1995 Population Census. Poisson regression analyses were made with the total and the gainfully employed workforce aged 20-64 y as reference. All 48 public and seven private acute care general hospitals treating LIDD patients in Finland. In the workforce, 4643 patients aged 20-64 y (3692 among the gainfully employed) were admitted to the hospital due to LIDD (ICD-10: M51.1-M51.9) in 1996. About one-half were treated surgically. The duration of unemployment in 1995 was inversely associated with hospitalisation for LIDD in 1996, allowing for age, sex, education and personal income (unemployed for 12 months vs 0 months: rate ratio 0.66; 95% CI 0.57-0.77). Among those employed for 12 months in 1995, the level of education was inversely associated with the hospital admission rate. The rate was also higher in manual occupations as compared with the upper white-collar employees. The associations were clearer among the medically than the surgically treated patients. Hospitalisation for back disorder was, however, less common in the lowest income group as compared with the highest (0.65; 0.57-0.77) allowing for education, occupational class, age and sex. Women were less often admitted to the hospital than men, allowing for the socioeconomic factors (0.83; 0.77-0.90). When indicated by education or occupation, low socioeconomic status was associated with a relatively high rate of inpatient hospital care for LIDD. When indicated by personal income, the situation was the reverse. Unemployment and female gender predicted a relatively low rate of hospitalisation.
该研究的目的是描述芬兰腰椎间盘疾病（LIDD）住院治疗的社会经济和人口统计学决定因素。1996年芬兰医院出院登记册中的信息与1995年人口普查数据相联系。以20 - 64岁的全体劳动力和有酬劳动力为参照进行泊松回归分析。芬兰所有48家公立和7家私立急性护理综合医院都收治LIDD患者。在劳动力群体中，1996年有4643名20 - 64岁的患者（其中3692名是有酬劳动者）因LIDD（国际疾病分类第十版：M51.1 - M51.9）入院。约一半患者接受了手术治疗。1995年的失业时长与1996年LIDD住院治疗呈负相关，在考虑年龄、性别、教育程度和个人收入因素的情况下（失业12个月与0个月相比：率比为0.66；95%置信区间为0.57 - 0.77）。在1995年就业12个月的人群中，教育程度与住院率呈负相关。体力劳动者的住院率也高于白领阶层。这些关联在接受药物治疗的患者中比接受手术治疗的患者中更明显。然而，在考虑教育程度、职业阶层、年龄和性别因素后，最低收入组的背部疾病住院率低于最高收入组（0.65；0.57 - 0.77）。考虑社会经济因素后，女性入院的频率低于男性（0.83；0.77 - 0.90）。当以教育程度或职业来衡量时，社会经济地位低与LIDD住院治疗率相对较高相关。当以个人收入来衡量时，情况则相反。失业和女性性别预示着相对较低的住院率。
