Burt Jenni, Hooper Richard, Jessopp Lynda
Immediate Access Project, Department of General Practice and Primary Care, Guy's, King's and St Thomas' School of Medicine, 5 Lambeth Walk, London SE11 6SP.
J Public Health Med. 2003 Jun;25(2):174-6. doi: 10.1093/pubmed/fdg038.
Little is known about the utilization of NHS Direct by disadvantaged groups, in spite of the service aiming to be 'accessible to all'. This study investigates the relationship between use of NHS Direct and deprivation in one predominantly disadvantaged area.
Ward-level call rates to NHS Direct South East London over a 6 month period were calculated using postcode data. Jarman and Townsend scores were used as a proxy of deprivation in each ward. We performed negative binomial regression to investigate the relationship between deprivation score and rate of calls to NHS Direct.
There was a significant, non-linear (quadratic) effect of deprivation score on call rates; call rates were lower in both the most affluent and most deprived wards.
Calls to NHS Direct rise with increasing deprivation until, at extreme levels of deprivation, they subsequently decline. This challenges assumptions that NHS Direct is not utilized in deprived areas.
尽管国民保健服务热线旨在“人人可及”，但关于弱势群体对其利用情况的了解却很少。本研究调查了在一个主要为弱势群体的地区，国民保健服务热线的使用与贫困之间的关系。
利用邮政编码数据计算了伦敦东南部地区6个月内各病房向国民保健服务热线的呼叫率。使用贾曼和汤森得分作为每个病房贫困程度的指标。我们进行了负二项回归，以研究贫困得分与国民保健服务热线呼叫率之间的关系。
贫困得分对呼叫率有显著的非线性（二次）影响；最富裕和最贫困的病房呼叫率都较低。
向国民保健服务热线的呼叫随着贫困程度的增加而上升，直到在极端贫困水平时，呼叫率随后下降。这对国民保健服务热线在贫困地区未被利用的假设提出了挑战。
