Magarolas Rosa Gispert, Clot-Razquin G Guillem, Llanes Jaume March, Ramírez Adriana Freitas, Bou Ester Busquets, Ruíz-Ramos Miguel, Fernández Antoni Rivero
Servei d Informació i Estudis, Departament de Salut, Generalitat de Catalunya, Barcelona, España.
Rev Esp Salud Publica. 2009 Nov-Dec;83(6):821-34.
The prevalence of disability shows a high geographical variability and the identification of factors that could explain these variations can be useful to the heath and social welfare planning. Here the analysis of disability variations among autonomous regions in Spain is made taking into account individual and geographical setting factors together.
Data come from the Spanish Disability, Impairment and Health Status survey of 1999 and from Inebase both of the National Institute for Statistics. The prevalence of disability crude and adjusted by age was calculated for each autonomous region. Individual factors related to disability are identified by means of a logistic regression. The analysis accounting for both, individual and geographical setting factors was performed by means of a logistic regression of two levels.
Disability prevalence showed a maximum difference of 5.75 points among regions. In a logistic regression the region of residence was statistically significant (OR: 3.35 in the highest rated region related to the lowest) beside several individual factors: age (OR 40-64= 1.78 OR 65-79= 1.87 and OR >79= 3.34), sex (OR women= 0.66), working status (OR unemployment=2.25 OR housewife/student=1.39 y OR other=2.03), health status (OR regular= 1.69 OR bad/very bad= 2.05) and chronic diseases (OR 1-3=1.56 OR 4-6=1.82 OR > 6=2.59). Individual factors accounted for a very few variance at the two levels regression model (s=0.261) and none of the regional variables improved the model.
Individual factors do not explain enough the observed disability variations among the regions and none factor related to the geographical setting has been identified as statistically significant.
残疾患病率呈现出高度的地域差异,识别能够解释这些差异的因素对于健康和社会福利规划可能是有用的。在此,我们综合考虑个体因素和地理环境因素,对西班牙各自治区的残疾差异进行分析。
数据来自1999年西班牙残疾、损伤与健康状况调查以及国家统计局的Inebase。计算每个自治区未经调整和按年龄调整后的残疾患病率。通过逻辑回归确定与残疾相关的个体因素。通过两级逻辑回归对个体因素和地理环境因素进行综合分析。
各地区的残疾患病率最大差异为5.75个百分点。在逻辑回归中,除了几个个体因素外,居住地区具有统计学意义(最高评级地区与最低评级地区相比,比值比:3.35):年龄(40 - 64岁的比值比 = 1.78,65 - 79岁的比值比 = 1.87,大于79岁的比值比 = 3.34)、性别(女性的比值比 = 0.66)、工作状态(失业的比值比 = 2.25,家庭主妇/学生的比值比 = 1.39,其他的比值比 = 2.03)、健康状况(一般的比值比 = 1.69,差/非常差的比值比 = 2.05)以及慢性病(1 - 3种慢性病的比值比 = 1.56,4 - 6种慢性病的比值比 = 1.82,超过6种慢性病的比值比 = 2.59)。在两级回归模型中,个体因素仅解释了极少部分的方差(s = 0.261),且没有一个地区变量能改善该模型。
个体因素不足以充分解释各地区观察到的残疾差异,且未发现与地理环境相关的因素具有统计学意义。